Generated Narrative: Citation 264329

url: Citation 37024129 Benefits and harms of drug treatment for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials.

identifier: FEvIR Object Identifier/264329, https://pubmed.ncbi.nlm.nih.gov/37024129, Uniform Resource Identifier (URI)/urn:oid:2.16.840.1.113883.4.642.40.44.15.11

version: 2.0.0-ballot

title: 37024129 Benefits and harms of drug treatment for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials.

status: Active

date: 2024-11-21 14:09:14+0000

publisher: HL7 International / Clinical Decision Support

contact: HL7 International / Clinical Decision Support: http://www.hl7.org/Special/committees/dss

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approvalDate: 2023-04-10

lastReviewDate: 2023-04-11

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classifier: MEDLINE

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classifier: National Library of Medicine, Index Section

currentState: Medline Citation Status of Medline, PubMed PublicationStatus of epublish

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period: ?? --> 2023-04-06 20:43:00+0000

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period: ?? --> 2023-04-06

citedArtifact

identifier: https://pubmed.ncbi.nlm.nih.gov/37024129, https://www.ncbi.nlm.nih.gov/pmc//PMC10077111, https://doi.org/10.1136/bmj-2022-074068

Titles

-	Type	Language	Text
*	Primary title	English	Benefits and harms of drug treatment for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials.

Abstracts

-	Text	Copyright
*	OBJECTIVE: 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. <AbstractText Label="DESIGN">Systematic review and network meta-analysis. <AbstractText Label="DATA SOURCES">Ovid Medline, Embase, and Cochrane Central up to 14 October 2022. <AbstractText Label="ELIGIBILITY CRITERIA FOR SELECTING STUDIES">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. RESULTS: 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). CONCLUSIONS: 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. <AbstractText Label="SYSTEMATIC REVIEW REGISTRATION">PROSPERO CRD42022325948.	© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. No commercial re-use. See rights and permissions. Published by BMJ.

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entry

contributor: Shi Q

forenameInitials: Q

affiliation: 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.

entry

contributor: Nong K

forenameInitials: K

affiliation: 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.

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contributor: Vandvik PO

forenameInitials: PO

affiliation: Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway.

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contributor: Guyatt GH

forenameInitials: GH

affiliation: Department of Health Research Methods, Evidence and Impact, McMaster University, ON, Canada.

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contributor: Schnell O

forenameInitials: O

affiliation: Forschergruppe Diabetes eV at the Helmholtz Centre, Munich-Neuherberg, Germany.

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contributor: Rydén L

forenameInitials: L

affiliation: Department of Medicine K2, Karolinska Institutet, Stockholm, Sweden.

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contributor: Marx N

forenameInitials: N

affiliation: Clinic for Cardiology, Angiology, and Intensive Care Medicine, RWTH Aachen University, University Hospital Aachen, Aachen, Germany.

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contributor: Brosius FC

forenameInitials: FC

affiliation: Division of Nephrology, University of Arizona College of Medicine Tucson, Tucson, AZ, USA.

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contributor: Mustafa RA

forenameInitials: RA

affiliation: Department of Internal Medicine, Division of Nephrology and Hypertension, University of Kansas, Kansas City, MI, USA.

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contributor: Agarwal A

forenameInitials: A

affiliation:

• Department of Health Research Methods, Evidence and Impact, McMaster University, ON, Canada.
• Department of Medicine, McMaster University, Hamilton, ON, Canada.

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contributor: Zou X

forenameInitials: X

affiliation: 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.

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contributor: Mao Y

forenameInitials: Y

affiliation: Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China.

entry

contributor: Asadollahifar A

forenameInitials: A

affiliation: Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

entry

contributor: Chowdhury SR

forenameInitials: SR

affiliation: Department of Health Research Methods, Evidence and Impact, McMaster University, ON, Canada.

entry

contributor: Zhai C

forenameInitials: C

affiliation: Department of Cardiology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China.

entry

contributor: Gupta S

forenameInitials: S

affiliation: Department of Health Research Methods, Evidence and Impact, McMaster University, ON, Canada.

entry

contributor: Gao Y

forenameInitials: Y

affiliation:

• Department of Health Research Methods, Evidence and Impact, McMaster University, ON, Canada.
• Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.

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contributor: Lima JP

forenameInitials: JP

affiliation: Department of Health Research Methods, Evidence and Impact, McMaster University, ON, Canada.

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contributor: Numata K

forenameInitials: K

affiliation: Department of Emergency Medicine, St Marianna University School of Medicine, Kawasaki, Japan.

entry

contributor: Qiao Z

forenameInitials: Z

affiliation: West China School of Medicine, Sichuan University, Chengdu, China.

entry

contributor: Fan Q

forenameInitials: Q

affiliation: 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.

entry

contributor: Yang Q

forenameInitials: Q

affiliation: Department of Nephrology, National Clinical Research Centre for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.

entry

contributor: Jin Y

forenameInitials: Y

affiliation: Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.

entry

contributor: Ge L

forenameInitials: L

affiliation: Evidence-Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China.

entry

contributor: Yang Q

forenameInitials: Q

affiliation: Evidence-Based Nursing Centre, School of Nursing, Lanzhou University, Lanzhou, China.

entry

contributor: Zhu H

forenameInitials: H

affiliation: Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China.

entry

contributor: Yang F

forenameInitials: F

affiliation: Department of Endocrinology and Metabolism, Chengdu Fifth People's Hospital, Chengdu, China.

entry

contributor: Chen Z

forenameInitials: Z

affiliation: Evidence-Based Medicine Centre, Tianjin University of Traditional Chinese Medicine, Tianjin, China.

entry

contributor: Lu X

forenameInitials: X

affiliation: 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.

entry

contributor: He S

forenameInitials: S

affiliation: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, China.

entry

contributor: Chen X

forenameInitials: X

affiliation: Department of Endocrinology and Metabolism, First People's Hospital of Shuangliu District, Chengdu, China.

entry

contributor: Lyu X

forenameInitials: X

affiliation: Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.

entry

contributor: An X

forenameInitials: X

affiliation: 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.

entry

contributor: Chen Y

forenameInitials: Y

affiliation: Evidence-Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China.

entry

contributor: Hao Q

forenameInitials: Q

affiliation: School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.

entry

contributor: Standl E

forenameInitials: E

affiliation: Forschergruppe Diabetes eV at the Helmholtz Centre, Munich-Neuherberg, Germany.

entry

contributor: Siemieniuk R

forenameInitials: R

affiliation: Department of Health Research Methods, Evidence and Impact, McMaster University, ON, Canada.

entry

contributor: Agoritsas T

forenameInitials: T

affiliation:

• Department of Health Research Methods, Evidence and Impact, McMaster University, ON, Canada.
• Division of General Internal Medicine, Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland.

entry

contributor: Tian H

forenameInitials: H

affiliation: 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.

entry

contributor: Li S

forenameInitials: S

affiliation: 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 lisheyu@gmail.com.

Generated Narrative: Practitioner #contributor0

identifier: ORCID/0000-0003-4299-5889

name: Qingyang Shi

Generated Narrative: Practitioner #contributor1

name: Kailei Nong

Generated Narrative: Practitioner #contributor2

name: Per Olav Vandvik

Generated Narrative: Practitioner #contributor3

name: Gordon H Guyatt

Generated Narrative: Practitioner #contributor4

name: Oliver Schnell

Generated Narrative: Practitioner #contributor5

name: Lars Rydén

Generated Narrative: Practitioner #contributor6

name: Nikolaus Marx

Generated Narrative: Practitioner #contributor7

name: Frank C Brosius

Generated Narrative: Practitioner #contributor8

name: Reem A Mustafa

Generated Narrative: Practitioner #contributor9

name: Arnav Agarwal

Generated Narrative: Practitioner #contributor10

name: Xinyu Zou

Generated Narrative: Practitioner #contributor11

name: Yunhe Mao

Generated Narrative: Practitioner #contributor12

name: Aminreza Asadollahifar

Generated Narrative: Practitioner #contributor13

name: Saifur Rahman Chowdhury

Generated Narrative: Practitioner #contributor14

name: Chunjuan Zhai

Generated Narrative: Practitioner #contributor15

name: Sana Gupta

Generated Narrative: Practitioner #contributor16

name: Ya Gao

Generated Narrative: Practitioner #contributor17

name: João Pedro Lima

Generated Narrative: Practitioner #contributor18

name: Kenji Numata

Generated Narrative: Practitioner #contributor19

name: Zhi Qiao

Generated Narrative: Practitioner #contributor20

name: Qinlin Fan

Generated Narrative: Practitioner #contributor21

name: Qinbo Yang

Generated Narrative: Practitioner #contributor22

name: Yinghui Jin

Generated Narrative: Practitioner #contributor23

name: Long Ge

Generated Narrative: Practitioner #contributor24

name: Qiuyu Yang

Generated Narrative: Practitioner #contributor25

name: Hongfei Zhu

Generated Narrative: Practitioner #contributor26

name: Fan Yang

Generated Narrative: Practitioner #contributor27

name: Zhe Chen

Generated Narrative: Practitioner #contributor28

name: Xi Lu

Generated Narrative: Practitioner #contributor29

name: Siyu He

Generated Narrative: Practitioner #contributor30

name: Xiangyang Chen

Generated Narrative: Practitioner #contributor31

name: Xiafei Lyu

Generated Narrative: Practitioner #contributor32

name: Xingxing An

Generated Narrative: Practitioner #contributor33

name: Yaolong Chen

Generated Narrative: Practitioner #contributor34

name: Qiukui Hao

Generated Narrative: Practitioner #contributor35

name: Eberhard Standl

Generated Narrative: Practitioner #contributor36

name: Reed Siemieniuk

Generated Narrative: Practitioner #contributor37

name: Thomas Agoritsas

Generated Narrative: Practitioner #contributor38

name: Haoming Tian

Generated Narrative: Practitioner #contributor39

identifier: ORCID/0000-0003-0060-0287

name: Sheyu Li

Generated Narrative: ArtifactAssessment #meshHeading0

artifact: Citation 37024129 Benefits and harms of drug treatment for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials.

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