Benefits and harms of drug treatment for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials

AbstractObjectiveTo compare the benefits and harms of drug treatments for adults with type 2 diabetes, adding non-steroidal mineralocorticoid receptor antagonists (including finerenone) and tirzepatide (a dual glucose dependent insulinotropic polypeptide (GIP)/glucagon-like peptide-1 (GLP-1) recepto...

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Published in:BMJ (Online) Vol. 381; p. e074068
Main Authors: Shi, Qingyang, Nong, Kailei, Vandvik, Per Olav, Guyatt, Gordon H, Schnell, Oliver, Rydén, Lars, Marx, Nikolaus, Brosius, Frank C, Mustafa, Reem A, Agarwal, Arnav, Zou, Xinyu, Mao, Yunhe, Asadollahifar, Aminreza, Chowdhury, Saifur Rahman, Zhai, Chunjuan, Gupta, Sana, Gao, Ya, Lima, João Pedro, Numata, Kenji, Qiao, Zhi, Fan, Qinlin, Yang, Qinbo, Jin, Yinghui, Ge, Long, Yang, Qiuyu, Zhu, Hongfei, Yang, Fan, Chen, Zhe, Lu, Xi, He, Siyu, Chen, Xiangyang, Lyu, Xiafei, An, Xingxing, Chen, Yaolong, Hao, Qiukui, Standl, Eberhard, Siemieniuk, Reed, Agoritsas, Thomas, Tian, Haoming, Li, Sheyu
Format: Journal Article
Language:English
Published: England British Medical Journal Publishing Group 06.04.2023
BMJ Publishing Group LTD
Subjects:
Adult
Agonists
Antidiabetics
Bias
Body mass index
Body weight
Cardiovascular disease
Cerebral infarction
Clinical practice guidelines
Clinical trials
Congestive heart failure
Death
Diabetes
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - drug therapy
Drugs
Glucagon
Glucagon-like peptide 1
Glucagon-Like Peptide-1 Receptor - therapeutic use
Glucose
Heart Failure - drug therapy
Humans
Insulin
Kidney diseases
Kidney Failure, Chronic
Kidney transplants
Meta-analysis
Mineralocorticoid Receptor Antagonists - adverse effects
Myocardial infarction
Patients
Quality of Life
Randomized Controlled Trials as Topic
Renal failure
Sodium-glucose cotransporter
Sodium-Glucose Transporter 2 Inhibitors - adverse effects
Thiazolidinediones
ISSN:1756-1833, 1756-1833
Online Access:Get full text
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Abstract AbstractObjectiveTo compare the benefits and harms of drug treatments for adults with type 2 diabetes, adding non-steroidal mineralocorticoid receptor antagonists (including finerenone) and tirzepatide (a dual glucose dependent insulinotropic polypeptide (GIP)/glucagon-like peptide-1 (GLP-1) receptor agonist) to previously existing treatment options.DesignSystematic review and network meta-analysis.Data sourcesOvid Medline, Embase, and Cochrane Central up to 14 October 2022.Eligibility criteria for selecting studiesEligible randomised controlled trials compared drugs of interest in adults with type 2 diabetes. Eligible trials had a follow-up of 24 weeks or longer. Trials systematically comparing combinations of more than one drug treatment class with no drug, subgroup analyses of randomised controlled trials, and non-English language studies were deemed ineligible. Certainty of evidence was assessed following the GRADE (grading of recommendations, assessment, development and evaluation) approach.ResultsThe analysis identified 816 trials with 471 038 patients, together evaluating 13 different drug classes; all subsequent estimates refer to the comparison with standard treatments. Sodium glucose cotransporter-2 (SGLT-2) inhibitors (odds ratio 0.88, 95% confidence interval 0.83 to 0.94; high certainty) and GLP-1 receptor agonists (0.88, 0.82 to 0.93; high certainty) reduce all cause death; non-steroidal mineralocorticoid receptor antagonists, so far tested only with finerenone in patients with chronic kidney disease, probably reduce mortality (0.89, 0.79 to 1.00; moderate certainty); other drugs may not. The study confirmed the benefits of SGLT-2 inhibitors and GLP-1 receptor agonists in reducing cardiovascular death, non-fatal myocardial infarction, admission to hospital for heart failure, and end stage kidney disease. Finerenone probably reduces admissions to hospital for heart failure and end stage kidney disease, and possibly cardiovascular death. Only GLP-1 receptor agonists reduce non-fatal stroke; SGLT-2 inhibitors are superior to other drugs in reducing end stage kidney disease. GLP-1 receptor agonists and probably SGLT-2 inhibitors and tirzepatide improve quality of life. Reported harms were largely specific to drug class (eg, genital infections with SGLT-2 inhibitors, severe gastrointestinal adverse events with tirzepatide and GLP-1 receptor agonists, hyperkalaemia leading to admission to hospital with finerenone). Tirzepatide probably results in the largest reduction in body weight (mean difference −8.57 kg; moderate certainty). Basal insulin (mean difference 2.15 kg; moderate certainty) and thiazolidinediones (mean difference 2.81 kg; moderate certainty) probably result in the largest increases in body weight. Absolute benefits of SGLT-2 inhibitors, GLP-1 receptor agonists, and finerenone vary in people with type 2 diabetes, depending on baseline risks for cardiovascular and kidney outcomes (https://matchit.magicevidence.org/230125dist-diabetes).ConclusionsThis network meta-analysis extends knowledge beyond confirming the substantial benefits with the use of SGLT-2 inhibitors and GLP-1 receptor agonists in reducing adverse cardiovascular and kidney outcomes and death by adding information on finerenone and tirzepatide. These findings highlight the need for continuous assessment of scientific progress to introduce cutting edge updates in clinical practice guidelines for people with type 2 diabetes.Systematic review registrationPROSPERO CRD42022325948.
AbstractList To compare the benefits and harms of drug treatments for adults with type 2 diabetes, adding non-steroidal mineralocorticoid receptor antagonists (including finerenone) and tirzepatide (a dual glucose dependent insulinotropic polypeptide (GIP)/glucagon-like peptide-1 (GLP-1) receptor agonist) to previously existing treatment options. Systematic review and network meta-analysis. Ovid Medline, Embase, and Cochrane Central up to 14 October 2022. Eligible randomised controlled trials compared drugs of interest in adults with type 2 diabetes. Eligible trials had a follow-up of 24 weeks or longer. Trials systematically comparing combinations of more than one drug treatment class with no drug, subgroup analyses of randomised controlled trials, and non-English language studies were deemed ineligible. Certainty of evidence was assessed following the GRADE (grading of recommendations, assessment, development and evaluation) approach. The analysis identified 816 trials with 471 038 patients, together evaluating 13 different drug classes; all subsequent estimates refer to the comparison with standard treatments. Sodium glucose cotransporter-2 (SGLT-2) inhibitors (odds ratio 0.88, 95% confidence interval 0.83 to 0.94; high certainty) and GLP-1 receptor agonists (0.88, 0.82 to 0.93; high certainty) reduce all cause death; non-steroidal mineralocorticoid receptor antagonists, so far tested only with finerenone in patients with chronic kidney disease, probably reduce mortality (0.89, 0.79 to 1.00; moderate certainty); other drugs may not. The study confirmed the benefits of SGLT-2 inhibitors and GLP-1 receptor agonists in reducing cardiovascular death, non-fatal myocardial infarction, admission to hospital for heart failure, and end stage kidney disease. Finerenone probably reduces admissions to hospital for heart failure and end stage kidney disease, and possibly cardiovascular death. Only GLP-1 receptor agonists reduce non-fatal stroke; SGLT-2 inhibitors are superior to other drugs in reducing end stage kidney disease. GLP-1 receptor agonists and probably SGLT-2 inhibitors and tirzepatide improve quality of life. Reported harms were largely specific to drug class (eg, genital infections with SGLT-2 inhibitors, severe gastrointestinal adverse events with tirzepatide and GLP-1 receptor agonists, hyperkalaemia leading to admission to hospital with finerenone). Tirzepatide probably results in the largest reduction in body weight (mean difference -8.57 kg; moderate certainty). Basal insulin (mean difference 2.15 kg; moderate certainty) and thiazolidinediones (mean difference 2.81 kg; moderate certainty) probably result in the largest increases in body weight. Absolute benefits of SGLT-2 inhibitors, GLP-1 receptor agonists, and finerenone vary in people with type 2 diabetes, depending on baseline risks for cardiovascular and kidney outcomes (https://matchit.magicevidence.org/230125dist-diabetes). This network meta-analysis extends knowledge beyond confirming the substantial benefits with the use of SGLT-2 inhibitors and GLP-1 receptor agonists in reducing adverse cardiovascular and kidney outcomes and death by adding information on finerenone and tirzepatide. These findings highlight the need for continuous assessment of scientific progress to introduce cutting edge updates in clinical practice guidelines for people with type 2 diabetes. PROSPERO CRD42022325948.
To compare the benefits and harms of drug treatments for adults with type 2 diabetes, adding non-steroidal mineralocorticoid receptor antagonists (including finerenone) and tirzepatide (a dual glucose dependent insulinotropic polypeptide (GIP)/glucagon-like peptide-1 (GLP-1) receptor agonist) to previously existing treatment options.OBJECTIVETo compare the benefits and harms of drug treatments for adults with type 2 diabetes, adding non-steroidal mineralocorticoid receptor antagonists (including finerenone) and tirzepatide (a dual glucose dependent insulinotropic polypeptide (GIP)/glucagon-like peptide-1 (GLP-1) receptor agonist) to previously existing treatment options.Systematic review and network meta-analysis.DESIGNSystematic review and network meta-analysis.Ovid Medline, Embase, and Cochrane Central up to 14 October 2022.DATA SOURCESOvid Medline, Embase, and Cochrane Central up to 14 October 2022.Eligible randomised controlled trials compared drugs of interest in adults with type 2 diabetes. Eligible trials had a follow-up of 24 weeks or longer. Trials systematically comparing combinations of more than one drug treatment class with no drug, subgroup analyses of randomised controlled trials, and non-English language studies were deemed ineligible. Certainty of evidence was assessed following the GRADE (grading of recommendations, assessment, development and evaluation) approach.ELIGIBILITY CRITERIA FOR SELECTING STUDIESEligible randomised controlled trials compared drugs of interest in adults with type 2 diabetes. Eligible trials had a follow-up of 24 weeks or longer. Trials systematically comparing combinations of more than one drug treatment class with no drug, subgroup analyses of randomised controlled trials, and non-English language studies were deemed ineligible. Certainty of evidence was assessed following the GRADE (grading of recommendations, assessment, development and evaluation) approach.The analysis identified 816 trials with 471 038 patients, together evaluating 13 different drug classes; all subsequent estimates refer to the comparison with standard treatments. Sodium glucose cotransporter-2 (SGLT-2) inhibitors (odds ratio 0.88, 95% confidence interval 0.83 to 0.94; high certainty) and GLP-1 receptor agonists (0.88, 0.82 to 0.93; high certainty) reduce all cause death; non-steroidal mineralocorticoid receptor antagonists, so far tested only with finerenone in patients with chronic kidney disease, probably reduce mortality (0.89, 0.79 to 1.00; moderate certainty); other drugs may not. The study confirmed the benefits of SGLT-2 inhibitors and GLP-1 receptor agonists in reducing cardiovascular death, non-fatal myocardial infarction, admission to hospital for heart failure, and end stage kidney disease. Finerenone probably reduces admissions to hospital for heart failure and end stage kidney disease, and possibly cardiovascular death. Only GLP-1 receptor agonists reduce non-fatal stroke; SGLT-2 inhibitors are superior to other drugs in reducing end stage kidney disease. GLP-1 receptor agonists and probably SGLT-2 inhibitors and tirzepatide improve quality of life. Reported harms were largely specific to drug class (eg, genital infections with SGLT-2 inhibitors, severe gastrointestinal adverse events with tirzepatide and GLP-1 receptor agonists, hyperkalaemia leading to admission to hospital with finerenone). Tirzepatide probably results in the largest reduction in body weight (mean difference -8.57 kg; moderate certainty). Basal insulin (mean difference 2.15 kg; moderate certainty) and thiazolidinediones (mean difference 2.81 kg; moderate certainty) probably result in the largest increases in body weight. Absolute benefits of SGLT-2 inhibitors, GLP-1 receptor agonists, and finerenone vary in people with type 2 diabetes, depending on baseline risks for cardiovascular and kidney outcomes (https://matchit.magicevidence.org/230125dist-diabetes).RESULTSThe analysis identified 816 trials with 471 038 patients, together evaluating 13 different drug classes; all subsequent estimates refer to the comparison with standard treatments. Sodium glucose cotransporter-2 (SGLT-2) inhibitors (odds ratio 0.88, 95% confidence interval 0.83 to 0.94; high certainty) and GLP-1 receptor agonists (0.88, 0.82 to 0.93; high certainty) reduce all cause death; non-steroidal mineralocorticoid receptor antagonists, so far tested only with finerenone in patients with chronic kidney disease, probably reduce mortality (0.89, 0.79 to 1.00; moderate certainty); other drugs may not. The study confirmed the benefits of SGLT-2 inhibitors and GLP-1 receptor agonists in reducing cardiovascular death, non-fatal myocardial infarction, admission to hospital for heart failure, and end stage kidney disease. Finerenone probably reduces admissions to hospital for heart failure and end stage kidney disease, and possibly cardiovascular death. Only GLP-1 receptor agonists reduce non-fatal stroke; SGLT-2 inhibitors are superior to other drugs in reducing end stage kidney disease. GLP-1 receptor agonists and probably SGLT-2 inhibitors and tirzepatide improve quality of life. Reported harms were largely specific to drug class (eg, genital infections with SGLT-2 inhibitors, severe gastrointestinal adverse events with tirzepatide and GLP-1 receptor agonists, hyperkalaemia leading to admission to hospital with finerenone). Tirzepatide probably results in the largest reduction in body weight (mean difference -8.57 kg; moderate certainty). Basal insulin (mean difference 2.15 kg; moderate certainty) and thiazolidinediones (mean difference 2.81 kg; moderate certainty) probably result in the largest increases in body weight. Absolute benefits of SGLT-2 inhibitors, GLP-1 receptor agonists, and finerenone vary in people with type 2 diabetes, depending on baseline risks for cardiovascular and kidney outcomes (https://matchit.magicevidence.org/230125dist-diabetes).This network meta-analysis extends knowledge beyond confirming the substantial benefits with the use of SGLT-2 inhibitors and GLP-1 receptor agonists in reducing adverse cardiovascular and kidney outcomes and death by adding information on finerenone and tirzepatide. These findings highlight the need for continuous assessment of scientific progress to introduce cutting edge updates in clinical practice guidelines for people with type 2 diabetes.CONCLUSIONSThis network meta-analysis extends knowledge beyond confirming the substantial benefits with the use of SGLT-2 inhibitors and GLP-1 receptor agonists in reducing adverse cardiovascular and kidney outcomes and death by adding information on finerenone and tirzepatide. These findings highlight the need for continuous assessment of scientific progress to introduce cutting edge updates in clinical practice guidelines for people with type 2 diabetes.PROSPERO CRD42022325948.SYSTEMATIC REVIEW REGISTRATIONPROSPERO CRD42022325948.
ObjectiveTo compare the benefits and harms of drug treatments for adults with type 2 diabetes, adding non-steroidal mineralocorticoid receptor antagonists (including finerenone) and tirzepatide (a dual glucose dependent insulinotropic polypeptide (GIP)/glucagon-like peptide-1 (GLP-1) receptor agonist) to previously existing treatment options.DesignSystematic review and network meta-analysis.Data sourcesOvid Medline, Embase, and Cochrane Central up to 14 October 2022.Eligibility criteria for selecting studiesEligible randomised controlled trials compared drugs of interest in adults with type 2 diabetes. Eligible trials had a follow-up of 24 weeks or longer. Trials systematically comparing combinations of more than one drug treatment class with no drug, subgroup analyses of randomised controlled trials, and non-English language studies were deemed ineligible. Certainty of evidence was assessed following the GRADE (grading of recommendations, assessment, development and evaluation) approach.ResultsThe analysis identified 816 trials with 471 038 patients, together evaluating 13 different drug classes; all subsequent estimates refer to the comparison with standard treatments. Sodium glucose cotransporter-2 (SGLT-2) inhibitors (odds ratio 0.88, 95% confidence interval 0.83 to 0.94; high certainty) and GLP-1 receptor agonists (0.88, 0.82 to 0.93; high certainty) reduce all cause death; non-steroidal mineralocorticoid receptor antagonists, so far tested only with finerenone in patients with chronic kidney disease, probably reduce mortality (0.89, 0.79 to 1.00; moderate certainty); other drugs may not. The study confirmed the benefits of SGLT-2 inhibitors and GLP-1 receptor agonists in reducing cardiovascular death, non-fatal myocardial infarction, admission to hospital for heart failure, and end stage kidney disease. Finerenone probably reduces admissions to hospital for heart failure and end stage kidney disease, and possibly cardiovascular death. Only GLP-1 receptor agonists reduce non-fatal stroke; SGLT-2 inhibitors are superior to other drugs in reducing end stage kidney disease. GLP-1 receptor agonists and probably SGLT-2 inhibitors and tirzepatide improve quality of life. Reported harms were largely specific to drug class (eg, genital infections with SGLT-2 inhibitors, severe gastrointestinal adverse events with tirzepatide and GLP-1 receptor agonists, hyperkalaemia leading to admission to hospital with finerenone). Tirzepatide probably results in the largest reduction in body weight (mean difference −8.57 kg; moderate certainty). Basal insulin (mean difference 2.15 kg; moderate certainty) and thiazolidinediones (mean difference 2.81 kg; moderate certainty) probably result in the largest increases in body weight. Absolute benefits of SGLT-2 inhibitors, GLP-1 receptor agonists, and finerenone vary in people with type 2 diabetes, depending on baseline risks for cardiovascular and kidney outcomes (https://matchit.magicevidence.org/230125dist-diabetes).ConclusionsThis network meta-analysis extends knowledge beyond confirming the substantial benefits with the use of SGLT-2 inhibitors and GLP-1 receptor agonists in reducing adverse cardiovascular and kidney outcomes and death by adding information on finerenone and tirzepatide. These findings highlight the need for continuous assessment of scientific progress to introduce cutting edge updates in clinical practice guidelines for people with type 2 diabetes.Systematic review registrationPROSPERO CRD42022325948.
AbstractObjectiveTo compare the benefits and harms of drug treatments for adults with type 2 diabetes, adding non-steroidal mineralocorticoid receptor antagonists (including finerenone) and tirzepatide (a dual glucose dependent insulinotropic polypeptide (GIP)/glucagon-like peptide-1 (GLP-1) receptor agonist) to previously existing treatment options.DesignSystematic review and network meta-analysis.Data sourcesOvid Medline, Embase, and Cochrane Central up to 14 October 2022.Eligibility criteria for selecting studiesEligible randomised controlled trials compared drugs of interest in adults with type 2 diabetes. Eligible trials had a follow-up of 24 weeks or longer. Trials systematically comparing combinations of more than one drug treatment class with no drug, subgroup analyses of randomised controlled trials, and non-English language studies were deemed ineligible. Certainty of evidence was assessed following the GRADE (grading of recommendations, assessment, development and evaluation) approach.ResultsThe analysis identified 816 trials with 471 038 patients, together evaluating 13 different drug classes; all subsequent estimates refer to the comparison with standard treatments. Sodium glucose cotransporter-2 (SGLT-2) inhibitors (odds ratio 0.88, 95% confidence interval 0.83 to 0.94; high certainty) and GLP-1 receptor agonists (0.88, 0.82 to 0.93; high certainty) reduce all cause death; non-steroidal mineralocorticoid receptor antagonists, so far tested only with finerenone in patients with chronic kidney disease, probably reduce mortality (0.89, 0.79 to 1.00; moderate certainty); other drugs may not. The study confirmed the benefits of SGLT-2 inhibitors and GLP-1 receptor agonists in reducing cardiovascular death, non-fatal myocardial infarction, admission to hospital for heart failure, and end stage kidney disease. Finerenone probably reduces admissions to hospital for heart failure and end stage kidney disease, and possibly cardiovascular death. Only GLP-1 receptor agonists reduce non-fatal stroke; SGLT-2 inhibitors are superior to other drugs in reducing end stage kidney disease. GLP-1 receptor agonists and probably SGLT-2 inhibitors and tirzepatide improve quality of life. Reported harms were largely specific to drug class (eg, genital infections with SGLT-2 inhibitors, severe gastrointestinal adverse events with tirzepatide and GLP-1 receptor agonists, hyperkalaemia leading to admission to hospital with finerenone). Tirzepatide probably results in the largest reduction in body weight (mean difference −8.57 kg; moderate certainty). Basal insulin (mean difference 2.15 kg; moderate certainty) and thiazolidinediones (mean difference 2.81 kg; moderate certainty) probably result in the largest increases in body weight. Absolute benefits of SGLT-2 inhibitors, GLP-1 receptor agonists, and finerenone vary in people with type 2 diabetes, depending on baseline risks for cardiovascular and kidney outcomes (https://matchit.magicevidence.org/230125dist-diabetes).ConclusionsThis network meta-analysis extends knowledge beyond confirming the substantial benefits with the use of SGLT-2 inhibitors and GLP-1 receptor agonists in reducing adverse cardiovascular and kidney outcomes and death by adding information on finerenone and tirzepatide. These findings highlight the need for continuous assessment of scientific progress to introduce cutting edge updates in clinical practice guidelines for people with type 2 diabetes.Systematic review registrationPROSPERO CRD42022325948.
Author Schnell, Oliver
Gao, Ya
Standl, Eberhard
Rydén, Lars
Tian, Haoming
Marx, Nikolaus
Hao, Qiukui
Chen, Xiangyang
Vandvik, Per Olav
He, Siyu
Ge, Long
Lyu, Xiafei
Guyatt, Gordon H
Yang, Qiuyu
An, Xingxing
Zhu, Hongfei
Mao, Yunhe
Chowdhury, Saifur Rahman
Mustafa, Reem A
Lima, João Pedro
Gupta, Sana
Zhai, Chunjuan
Lu, Xi
Chen, Zhe
Shi, Qingyang
Siemieniuk, Reed
Yang, Qinbo
Jin, Yinghui
Agarwal, Arnav
Qiao, Zhi
Chen, Yaolong
Li, Sheyu
Brosius, Frank C
Nong, Kailei
Agoritsas, Thomas
Fan, Qinlin
Numata, Kenji
Yang, Fan
Asadollahifar, Aminreza
Zou, Xinyu
Author_xml – sequence: 1
  givenname: Qingyang
  orcidid: 0000-0003-4299-5889
  surname: Shi
  fullname: Shi, Qingyang
  organization: Department of Endocrinology and Metabolism, Division of Guideline and Rapid Recommendation, Cochrane China Centre, MAGIC China Centre, Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, China
– sequence: 2
  givenname: Kailei
  surname: Nong
  fullname: Nong, Kailei
  organization: Department of Endocrinology and Metabolism, Division of Guideline and Rapid Recommendation, Cochrane China Centre, MAGIC China Centre, Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, China
– sequence: 3
  givenname: Per Olav
  surname: Vandvik
  fullname: Vandvik, Per Olav
  organization: Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway
– sequence: 4
  givenname: Gordon H
  surname: Guyatt
  fullname: Guyatt, Gordon H
  organization: Department of Health Research Methods, Evidence and Impact, McMaster University, ON, Canada
– sequence: 5
  givenname: Oliver
  surname: Schnell
  fullname: Schnell, Oliver
  organization: Forschergruppe Diabetes eV at the Helmholtz Centre, Munich-Neuherberg, Germany
– sequence: 6
  givenname: Lars
  surname: Rydén
  fullname: Rydén, Lars
  organization: Department of Medicine K2, Karolinska Institutet, Stockholm, Sweden
– sequence: 7
  givenname: Nikolaus
  surname: Marx
  fullname: Marx, Nikolaus
  organization: Clinic for Cardiology, Angiology, and Intensive Care Medicine, RWTH Aachen University, University Hospital Aachen, Aachen, Germany
– sequence: 8
  givenname: Frank C
  surname: Brosius
  fullname: Brosius, Frank C
  organization: Division of Nephrology, University of Arizona College of Medicine Tucson, Tucson, AZ, USA
– sequence: 9
  givenname: Reem A
  surname: Mustafa
  fullname: Mustafa, Reem A
  organization: Department of Internal Medicine, Division of Nephrology and Hypertension, University of Kansas, Kansas City, MI, USA
– sequence: 10
  givenname: Arnav
  surname: Agarwal
  fullname: Agarwal, Arnav
  organization: Department of Medicine, McMaster University, Hamilton, ON, Canada
– sequence: 11
  givenname: Xinyu
  surname: Zou
  fullname: Zou, Xinyu
  organization: Department of Endocrinology and Metabolism, Division of Guideline and Rapid Recommendation, Cochrane China Centre, MAGIC China Centre, Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, China
– sequence: 12
  givenname: Yunhe
  surname: Mao
  fullname: Mao, Yunhe
  organization: Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
– sequence: 13
  givenname: Aminreza
  surname: Asadollahifar
  fullname: Asadollahifar, Aminreza
  organization: Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
– sequence: 14
  givenname: Saifur Rahman
  surname: Chowdhury
  fullname: Chowdhury, Saifur Rahman
  organization: Department of Health Research Methods, Evidence and Impact, McMaster University, ON, Canada
– sequence: 15
  givenname: Chunjuan
  surname: Zhai
  fullname: Zhai, Chunjuan
  organization: Department of Cardiology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
– sequence: 16
  givenname: Sana
  surname: Gupta
  fullname: Gupta, Sana
  organization: Department of Health Research Methods, Evidence and Impact, McMaster University, ON, Canada
– sequence: 17
  givenname: Ya
  surname: Gao
  fullname: Gao, Ya
  organization: Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
– sequence: 18
  givenname: João Pedro
  surname: Lima
  fullname: Lima, João Pedro
  organization: Department of Health Research Methods, Evidence and Impact, McMaster University, ON, Canada
– sequence: 19
  givenname: Kenji
  surname: Numata
  fullname: Numata, Kenji
  organization: Department of Emergency Medicine, St Marianna University School of Medicine, Kawasaki, Japan
– sequence: 20
  givenname: Zhi
  surname: Qiao
  fullname: Qiao, Zhi
  organization: West China School of Medicine, Sichuan University, Chengdu, China
– sequence: 21
  givenname: Qinlin
  surname: Fan
  fullname: Fan, Qinlin
  organization: Department of Endocrinology and Metabolism, Division of Guideline and Rapid Recommendation, Cochrane China Centre, MAGIC China Centre, Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, China
– sequence: 22
  givenname: Qinbo
  surname: Yang
  fullname: Yang, Qinbo
  organization: Department of Nephrology, National Clinical Research Centre for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
– sequence: 23
  givenname: Yinghui
  surname: Jin
  fullname: Jin, Yinghui
  organization: Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
– sequence: 24
  givenname: Long
  surname: Ge
  fullname: Ge, Long
  organization: Evidence-Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China
– sequence: 25
  givenname: Qiuyu
  surname: Yang
  fullname: Yang, Qiuyu
  organization: Evidence-Based Nursing Centre, School of Nursing, Lanzhou University, Lanzhou, China
– sequence: 26
  givenname: Hongfei
  surname: Zhu
  fullname: Zhu, Hongfei
  organization: Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
– sequence: 27
  givenname: Fan
  surname: Yang
  fullname: Yang, Fan
  organization: Department of Endocrinology and Metabolism, Chengdu Fifth People’s Hospital, Chengdu, China
– sequence: 28
  givenname: Zhe
  surname: Chen
  fullname: Chen, Zhe
  organization: Evidence-Based Medicine Centre, Tianjin University of Traditional Chinese Medicine, Tianjin, China
– sequence: 29
  givenname: Xi
  surname: Lu
  fullname: Lu, Xi
  organization: Department of Endocrinology and Metabolism, Division of Guideline and Rapid Recommendation, Cochrane China Centre, MAGIC China Centre, Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, China
– sequence: 30
  givenname: Siyu
  surname: He
  fullname: He, Siyu
  organization: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, China
– sequence: 31
  givenname: Xiangyang
  surname: Chen
  fullname: Chen, Xiangyang
  organization: Department of Endocrinology and Metabolism, First People’s Hospital of Shuangliu District, Chengdu, China
– sequence: 32
  givenname: Xiafei
  surname: Lyu
  fullname: Lyu, Xiafei
  organization: Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
– sequence: 33
  givenname: Xingxing
  surname: An
  fullname: An, Xingxing
  organization: Department of Endocrinology and Metabolism, Division of Guideline and Rapid Recommendation, Cochrane China Centre, MAGIC China Centre, Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, China
– sequence: 34
  givenname: Yaolong
  surname: Chen
  fullname: Chen, Yaolong
  organization: Evidence-Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China
– sequence: 35
  givenname: Qiukui
  surname: Hao
  fullname: Hao, Qiukui
  organization: School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
– sequence: 36
  givenname: Eberhard
  surname: Standl
  fullname: Standl, Eberhard
  organization: Forschergruppe Diabetes eV at the Helmholtz Centre, Munich-Neuherberg, Germany
– sequence: 37
  givenname: Reed
  surname: Siemieniuk
  fullname: Siemieniuk, Reed
  organization: Department of Health Research Methods, Evidence and Impact, McMaster University, ON, Canada
– sequence: 38
  givenname: Thomas
  surname: Agoritsas
  fullname: Agoritsas, Thomas
  organization: Division of General Internal Medicine, Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland
– sequence: 39
  givenname: Haoming
  surname: Tian
  fullname: Tian, Haoming
  organization: Department of Endocrinology and Metabolism, Division of Guideline and Rapid Recommendation, Cochrane China Centre, MAGIC China Centre, Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, China
– sequence: 40
  givenname: Sheyu
  orcidid: 0000-0003-0060-0287
  surname: Li
  fullname: Li, Sheyu
  email: lisheyu@gmail.com
  organization: Department of Endocrinology and Metabolism, Division of Guideline and Rapid Recommendation, Cochrane China Centre, MAGIC China Centre, Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, China
BackLink https://www.ncbi.nlm.nih.gov/pubmed/37024129$$D View this record in MEDLINE/PubMed
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Snippet AbstractObjectiveTo compare the benefits and harms of drug treatments for adults with type 2 diabetes, adding non-steroidal mineralocorticoid receptor...
To compare the benefits and harms of drug treatments for adults with type 2 diabetes, adding non-steroidal mineralocorticoid receptor antagonists (including...
ObjectiveTo compare the benefits and harms of drug treatments for adults with type 2 diabetes, adding non-steroidal mineralocorticoid receptor antagonists...
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StartPage e074068
SubjectTerms Adult
Agonists
Antidiabetics
Bias
Body mass index
Body weight
Cardiovascular disease
Cerebral infarction
Clinical practice guidelines
Clinical trials
Congestive heart failure
Death
Diabetes
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - drug therapy
Drugs
Glucagon
Glucagon-like peptide 1
Glucagon-Like Peptide-1 Receptor - therapeutic use
Glucose
Heart Failure - drug therapy
Humans
Insulin
Kidney diseases
Kidney Failure, Chronic
Kidney transplants
Meta-analysis
Mineralocorticoid Receptor Antagonists - adverse effects
Myocardial infarction
Patients
Quality of Life
Randomized Controlled Trials as Topic
Renal failure
Sodium-glucose cotransporter
Sodium-Glucose Transporter 2 Inhibitors - adverse effects
Thiazolidinediones
Title Benefits and harms of drug treatment for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials
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https://www.ncbi.nlm.nih.gov/pubmed/37024129
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