Absolute treatment effects of novel antidiabetic drugs on a composite renal outcome: meta-analysis of digitalized individual patient data
Background: Absolute treatment benefits—expressed as numbers needed to treat—of the glucose lowering and cardiovascular drugs, glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose transporter 2 (SGLT2) inhibitors on renal outcomes remain uncertain. With the present meta-analysis of d...
Main Authors: | , , , , , , , , , , |
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Format: | Journal article |
Language: | English |
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Springer
2024
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_version_ | 1811139987424411648 |
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author | Brockmeyer, M Parco, C Vargas, KG Westenfeld, R Jung, C Kelm, M Roden, M Akbulut, C Schlesinger, S Wolff, G Kuss, O |
author_facet | Brockmeyer, M Parco, C Vargas, KG Westenfeld, R Jung, C Kelm, M Roden, M Akbulut, C Schlesinger, S Wolff, G Kuss, O |
author_sort | Brockmeyer, M |
collection | OXFORD |
description | Background: Absolute treatment benefits—expressed as numbers needed to treat—of the glucose lowering and cardiovascular drugs, glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose transporter 2 (SGLT2) inhibitors on renal outcomes remain uncertain. With the present meta-analysis of digitalized individual patient data, we aimed to display and compare numbers needed to treat of both drugs on a composite renal outcome. Methods: From Kaplan–Meier plots of major cardiovascular outcome trials of GLP-1 receptor agonists and SGLT2 inhibitors vs. placebo, we digitalized individual patient time-to-event information on composite renal outcomes with WebPlotDigitizer 4.2; numbers needed to treat from individual cardiovascular outcome trials were estimated using parametric Weibull regression models and compared to original data. Random-effects meta-analysis generated meta-numbers needed to treat with 95% confidence intervals (CI). Results: Twelve cardiovascular outcome trials (three for GLP-1 receptor agonists, nine for SGLT2 inhibitors) comprising 90,865 participants were included. Eight trials were conducted in primary type 2 diabetes populations, two in a primary heart failure and two in a primary chronic kidney disease population. Mean estimated glomerular filtration rate at baseline ranged between 37.3 and 85.3 ml/min/1.73 m2. Meta-analyses estimated meta-numbers needed to treat of 85 (95% CI 60; 145) for GLP-1 receptor agonists and 104 (95% CI 81; 147) for SGLT2 inhibitors for the composite renal outcome at the overall median follow-up time of 36 months. Conclusion: The present meta-analysis of digitalized individual patient data revealed moderate and similar absolute treatment benefits of GLP-1 receptor agonists and SGLT2 inhibitors compared to placebo for a composite renal outcome. Graphical Abstract: |
first_indexed | 2024-09-25T04:14:49Z |
format | Journal article |
id | oxford-uuid:066446b5-3fe9-40b5-b2fe-6683acbc977b |
institution | University of Oxford |
language | English |
last_indexed | 2024-09-25T04:14:49Z |
publishDate | 2024 |
publisher | Springer |
record_format | dspace |
spelling | oxford-uuid:066446b5-3fe9-40b5-b2fe-6683acbc977b2024-07-20T14:11:32ZAbsolute treatment effects of novel antidiabetic drugs on a composite renal outcome: meta-analysis of digitalized individual patient dataJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:066446b5-3fe9-40b5-b2fe-6683acbc977bEnglishJisc Publications RouterSpringer2024Brockmeyer, MParco, CVargas, KGWestenfeld, RJung, CKelm, MRoden, MAkbulut, CSchlesinger, SWolff, GKuss, OBackground: Absolute treatment benefits—expressed as numbers needed to treat—of the glucose lowering and cardiovascular drugs, glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose transporter 2 (SGLT2) inhibitors on renal outcomes remain uncertain. With the present meta-analysis of digitalized individual patient data, we aimed to display and compare numbers needed to treat of both drugs on a composite renal outcome. Methods: From Kaplan–Meier plots of major cardiovascular outcome trials of GLP-1 receptor agonists and SGLT2 inhibitors vs. placebo, we digitalized individual patient time-to-event information on composite renal outcomes with WebPlotDigitizer 4.2; numbers needed to treat from individual cardiovascular outcome trials were estimated using parametric Weibull regression models and compared to original data. Random-effects meta-analysis generated meta-numbers needed to treat with 95% confidence intervals (CI). Results: Twelve cardiovascular outcome trials (three for GLP-1 receptor agonists, nine for SGLT2 inhibitors) comprising 90,865 participants were included. Eight trials were conducted in primary type 2 diabetes populations, two in a primary heart failure and two in a primary chronic kidney disease population. Mean estimated glomerular filtration rate at baseline ranged between 37.3 and 85.3 ml/min/1.73 m2. Meta-analyses estimated meta-numbers needed to treat of 85 (95% CI 60; 145) for GLP-1 receptor agonists and 104 (95% CI 81; 147) for SGLT2 inhibitors for the composite renal outcome at the overall median follow-up time of 36 months. Conclusion: The present meta-analysis of digitalized individual patient data revealed moderate and similar absolute treatment benefits of GLP-1 receptor agonists and SGLT2 inhibitors compared to placebo for a composite renal outcome. Graphical Abstract: |
spellingShingle | Brockmeyer, M Parco, C Vargas, KG Westenfeld, R Jung, C Kelm, M Roden, M Akbulut, C Schlesinger, S Wolff, G Kuss, O Absolute treatment effects of novel antidiabetic drugs on a composite renal outcome: meta-analysis of digitalized individual patient data |
title | Absolute treatment effects of novel antidiabetic drugs on a composite renal outcome: meta-analysis of digitalized individual patient data |
title_full | Absolute treatment effects of novel antidiabetic drugs on a composite renal outcome: meta-analysis of digitalized individual patient data |
title_fullStr | Absolute treatment effects of novel antidiabetic drugs on a composite renal outcome: meta-analysis of digitalized individual patient data |
title_full_unstemmed | Absolute treatment effects of novel antidiabetic drugs on a composite renal outcome: meta-analysis of digitalized individual patient data |
title_short | Absolute treatment effects of novel antidiabetic drugs on a composite renal outcome: meta-analysis of digitalized individual patient data |
title_sort | absolute treatment effects of novel antidiabetic drugs on a composite renal outcome meta analysis of digitalized individual patient data |
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