Sammendrag
Sodium-glucose cotransporter-2 inhibitors (SGLT2i) improve cardiovascular outcomes in patients with type 2 diabetes mellitus
(T2D). The comparative efficacy of individual SGLT2i remains unclear. We searched PubMed, www.clinicaltrials.gov and the
Cochrane Central Register of Controlled Trials for randomised controlled trials exploring the use of canagliflozin, dapagliflozin,
empagliflozin or ertugliflozin in patients with T2D. Comparators included placebo or any other active treatment. The primary
endpoint was all-cause mortality. Secondary endpoints were cardiovascular mortality and worsening heart failure (HF). Evidence
was synthesised using network meta-analysis (NMA). Sixty-four trials reporting on 74,874 patients were included. The overall
quality of evidence was high. When compared with placebo, empagliflozin and canagliflozin improved all three endpoints,
whereas dapagliflozin improved worsening HF. When compared with other SGLT2i, empagliflozin was superior for all-cause
and cardiovascular mortality reduction. Empagliflozin, canagliflozin and dapagliflozin had similar effects on improving worsening HF. Ertugliflozin had no effect on any of the three endpoints investigated. Sensitivity analyses including extension periods
of trials or excluding studies with a treatment duration of
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