SGLT-2抑制剂及GLP-1受体激动剂治疗2型糖尿病的心血管获益:一项系统回顾和网状Meta分析
投稿时间:2021-09-23  修订日期:2021-12-30  点此下载全文
引用本文:赖彦岚,黄爱文,陈官旭,陈婷婷,赵丽君,廖小兰,郭秀强,吴刚,宋洪涛.SGLT-2抑制剂及GLP-1受体激动剂治疗2型糖尿病的心血管获益:一项系统回顾和网状Meta分析[J].药学实践杂志,2022,40(4):354~358
摘要点击次数: 53
全文下载次数: 42
作者单位E-mail
赖彦岚 中国人民解放军联勤保障部队第九OO医院临床药学科, 福建 福州 350025  
黄爱文 中国人民解放军联勤保障部队第九OO医院临床药学科, 福建 福州 350025  
陈官旭 中国人民解放军联勤保障部队第九OO医院临床药学科, 福建 福州 350025  
陈婷婷 中国人民解放军联勤保障部队第九OO医院临床药学科, 福建 福州 350025  
赵丽君 中国人民解放军联勤保障部队第九OO医院临床药学科, 福建 福州 350025  
廖小兰 中国人民解放军联勤保障部队第九OO医院临床药学科, 福建 福州 350025  
郭秀强 中国人民解放军联勤保障部队第九OO医院临床药学科, 福建 福州 350025  
吴刚 中国人民解放军联勤保障部队第九OO医院医学信息数据室, 福建 福州 350025  
宋洪涛 中国人民解放军联勤保障部队第九OO医院药剂科, 福建 福州 350025 sohoto@vip.163.com 
中文摘要:目的 通过贝叶斯网状Meta分析系统评价上市的11种钠-葡萄糖共转运蛋白-2(SGLT-2)抑制剂和胰高血糖素样多肽-1(GLP-1)受体激动剂治疗2型糖尿病患者的心血管获益。方法 检索Medline、Embase和Cochrane 数据库,检索日期为建库至2020年7月18日。研究终点为心血管不良事件,效应指标为风险比(hazard ratios, HR)及其95%可信区间(95% CI)。结果 与安慰剂相比,恩格列净、卡格列净、达格列净、阿必鲁肽、度拉糖肽、艾塞那肽、利拉鲁肽和索马鲁肽可降低2型糖尿病患者主要心血管不良事件的发生风险,HR及95%CI为0.75(0.60-0.95) ~0.90(0.82-0.99);恩格列净、卡格列净、达格列净和艾托格列净可降低心力衰竭的发生风险,HR及95%CI为0.64(0.49-0.82) ~0.74(0.65-0.85);恩格列净、卡格列净、达格列净、艾塞那肽、利拉鲁肽和口服索马鲁肽可降低全因死亡的发生风险,HR及95%CI为0.52(0.33-0.84)~0.89(0.80-0.99);恩格列净、卡格列净、利拉鲁肽和口服索马鲁肽可降低心血管死亡事件的发生风险,HR及95%CI为0.54(0.30-0.95) ~0.83(0.71-0.96) 。结论 应用SGLT-2抑制剂或GLP-1受体激动剂,对2型糖尿病合并动脉粥样硬化性心血管疾病患者的心血管获益依次是:卡格列净、恩格列净、度拉糖肽、利拉鲁肽;对2型糖尿病合并心衰的患者,心血管获益依次是:恩格列净、卡格列净、艾托格列净、达格列净。
中文关键词:钠-葡萄糖共转运蛋白-2抑制剂  胰高血糖素样多肽-1受体激动剂  2型糖尿病  心血管安全性  网络Meta分析
 
Cardiovascular benefits of SGLT-2 inhibitors and GLP-1 receptor agonists in type 2 diabetes: a systematic review and network meta-analysis
Abstract:Objective To evaluate cardiovascular benefits in patients with type 2 diabetes mellitus treated with the marketed 11 sodium-glucose co-transporter-2 (SGLT-2) inhibitors and glucagon-like polypeptide-1 (GLP-1) receptor agonism by Bayesian network meta-analysis system. Methods MEDLINE, Embase and Cochrane Library were searched from the establishment of the database to 18 July 2020. The endpoint of the study was adverse cardiovascular events. The effect measures were hazard ratios (HR) and 95% credible intervals (CI). Results Compared with placebo, empagliflozin, canagliflozin, dapagliflozin, albiglutide, dulaglutide, exenatide, liraglutide, semaglutide reduced the risk of major adverse cardiovascular events in patients with type 2 diabetes with HR and 95% CI ranging between 0.75(0.60-0.95)~0.90(0.82-0.99); The risk of heart failure was reduced by empagliflozin, canagliflozin, dapagliflozin and ertugliflozin, with HR and 95%CI ranging between 0.64(0.49-0.82)~0.74(0.65-0.85); Empagliflozin, canagliflozin, dapagliflozin, exenatide, liraglutide and oral semaglutide reduced the incidence of all-cause mortality with HR and 95%CI ranging between 0.52(0.33-0.84)~0.89(0.80-0.99); Empagliflozin, canagliflozin, liraglutide and oral semaglutide can reduce the risk of cardiovascular death events, with HR and 95% CI ranging between 0.54(0.30-0.95)~0.83(0.71-0.96) .Conclusion The order of the cardiovascular benefits of SGLT-2 inhibitors or GLP-1 receptor agonists in patients with type 2 diabetes mellitus complicated with atherosclerotic cardiovascular disease are canagliflozin (the best), empagliflozin, dulaglutide, liraglutide; for patients with type 2 diabetes and heart failure. The order of the cardiovascular benefits for patients with type 2 diabetes and heart failure are empagliflozin, canagliflozin, ertugliflozin, and dapagliflozin.
keywords:SGLT-2 inhibitors  GLP-1 receptor agonists  type 2 diabetes  cardiovascular benefits  network meta-analysis
查看全文  查看/发表评论  下载PDF阅读器
关闭

分享按钮