Sodium-glucose co-transporter-2 inhibitors: A cardiovascular outcome trial analysis

Cardiovascular outcome trials (CVOTs) have to be done by sponsors who wish to launch new antidiabetic drugs in the US, since the December 2008 US Food and Drug Administration ruling, which was subsequently accepted by the European Medicines (Evaluation) Agency (EMA) in 2012. However, the medical com...

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Main Author: Viraj Ramesh Suvarna
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2021-01-01
Series:Perspectives in Clinical Research
Subjects:
Online Access:http://www.picronline.org/article.asp?issn=2229-3485;year=2021;volume=12;issue=1;spage=4;epage=8;aulast=
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author Viraj Ramesh Suvarna
author_facet Viraj Ramesh Suvarna
author_sort Viraj Ramesh Suvarna
collection DOAJ
description Cardiovascular outcome trials (CVOTs) have to be done by sponsors who wish to launch new antidiabetic drugs in the US, since the December 2008 US Food and Drug Administration ruling, which was subsequently accepted by the European Medicines (Evaluation) Agency (EMA) in 2012. However, the medical community asks the question, “So What?” as they are not convinced of the clinical relevance of CVOTs. The patients selected in CVOTs are necessarily high risk, so that they develop major adverse cardiovascular events quickly, but then, the results are extrapolatable to only a certain percentage of patients seen in the clinical practice. Doctors believe that these trials only serve a regulatory need. At the same time, these trials do provide a lot of good data, but it needs to be interpreted well, and extrapolated appropriately to patients in practice as there are differences between what happens in a randomized control trial and in the real world. Hence, the need for this article which serves to dissect the CVOTs of sodium-glucose co-transporter-2 inhibitors, so that doctors are able to better read this evidence. However, the question of which gliflozin is the best cannot be answered by these trials as these are not head to head trials. All the more reason why one needs to look at the data holistically and be empowered to make the right decision for individual patients, hoping to match the best patient for the best drug, rather than determine which drug is better.
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spelling doaj.art-b5f163d711fd4107a89e0ef2236bd6152022-12-21T22:26:46ZengWolters Kluwer Medknow PublicationsPerspectives in Clinical Research2229-34852021-01-011214810.4103/picr.PICR_156_19Sodium-glucose co-transporter-2 inhibitors: A cardiovascular outcome trial analysisViraj Ramesh SuvarnaCardiovascular outcome trials (CVOTs) have to be done by sponsors who wish to launch new antidiabetic drugs in the US, since the December 2008 US Food and Drug Administration ruling, which was subsequently accepted by the European Medicines (Evaluation) Agency (EMA) in 2012. However, the medical community asks the question, “So What?” as they are not convinced of the clinical relevance of CVOTs. The patients selected in CVOTs are necessarily high risk, so that they develop major adverse cardiovascular events quickly, but then, the results are extrapolatable to only a certain percentage of patients seen in the clinical practice. Doctors believe that these trials only serve a regulatory need. At the same time, these trials do provide a lot of good data, but it needs to be interpreted well, and extrapolated appropriately to patients in practice as there are differences between what happens in a randomized control trial and in the real world. Hence, the need for this article which serves to dissect the CVOTs of sodium-glucose co-transporter-2 inhibitors, so that doctors are able to better read this evidence. However, the question of which gliflozin is the best cannot be answered by these trials as these are not head to head trials. All the more reason why one needs to look at the data holistically and be empowered to make the right decision for individual patients, hoping to match the best patient for the best drug, rather than determine which drug is better.http://www.picronline.org/article.asp?issn=2229-3485;year=2021;volume=12;issue=1;spage=4;epage=8;aulast=cardiovascular outcome trialmajor adverse cardiovascular eventnoninferioritysodium-glucose co-transporter-2 inhibitorssuperiority
spellingShingle Viraj Ramesh Suvarna
Sodium-glucose co-transporter-2 inhibitors: A cardiovascular outcome trial analysis
Perspectives in Clinical Research
cardiovascular outcome trial
major adverse cardiovascular event
noninferiority
sodium-glucose co-transporter-2 inhibitors
superiority
title Sodium-glucose co-transporter-2 inhibitors: A cardiovascular outcome trial analysis
title_full Sodium-glucose co-transporter-2 inhibitors: A cardiovascular outcome trial analysis
title_fullStr Sodium-glucose co-transporter-2 inhibitors: A cardiovascular outcome trial analysis
title_full_unstemmed Sodium-glucose co-transporter-2 inhibitors: A cardiovascular outcome trial analysis
title_short Sodium-glucose co-transporter-2 inhibitors: A cardiovascular outcome trial analysis
title_sort sodium glucose co transporter 2 inhibitors a cardiovascular outcome trial analysis
topic cardiovascular outcome trial
major adverse cardiovascular event
noninferiority
sodium-glucose co-transporter-2 inhibitors
superiority
url http://www.picronline.org/article.asp?issn=2229-3485;year=2021;volume=12;issue=1;spage=4;epage=8;aulast=
work_keys_str_mv AT virajrameshsuvarna sodiumglucosecotransporter2inhibitorsacardiovascularoutcometrialanalysis