Cargando…
Comparative efficacy of once-weekly semaglutide versus SGLT-2 inhibitors in patients inadequately controlled with one to two oral antidiabetic drugs: a systematic literature review and network meta-analysis
OBJECTIVE: To determine the comparative efficacy of once-weekly semaglutide relative to sodium-glucose cotransporter 2 inhibitors (SGLT-2is) licensed in Europe and North America among patients with type 2 diabetes (T2D) inadequately controlled with 1–2 oral antidiabetics (OADs), using a network meta...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6661926/ https://www.ncbi.nlm.nih.gov/pubmed/31340953 http://dx.doi.org/10.1136/bmjopen-2018-023458 |
_version_ | 1783439552019431424 |
---|---|
author | Kanters, Steve Wilkinson, Lars Vrazic, Hrvoje Sharma, Rohini Lopes, Sandra Popoff, Evan Druyts, Eric |
author_facet | Kanters, Steve Wilkinson, Lars Vrazic, Hrvoje Sharma, Rohini Lopes, Sandra Popoff, Evan Druyts, Eric |
author_sort | Kanters, Steve |
collection | PubMed |
description | OBJECTIVE: To determine the comparative efficacy of once-weekly semaglutide relative to sodium-glucose cotransporter 2 inhibitors (SGLT-2is) licensed in Europe and North America among patients with type 2 diabetes (T2D) inadequately controlled with 1–2 oral antidiabetics (OADs), using a network meta-analysis (NMA). Design systematic review and network meta-analysis. Data Sources EMBASE, MEDLINE and CENTRAL were searched from January 1994 to August 2017. METHODS: Randomised controlled trials with ≥20 weeks of treatment evaluating once-weekly semaglutide or SGLT-2is. Primary outcomes included change from baseline in: HbA1c, weight, systolic blood pressure, postprandial blood glucose and fasting plasma glucose. Fixed-effect and random-effect Bayesian NMA were used to indirectly compare treatment effects at 26 (±4) weeks. Metaregression and sensitivity analyses were conducted. Model selection was performed using the deviance information criterion and consistency was assessed by comparing indirect (edge-splitting) to direct evidence. RESULTS: Forty-eight publications representing 21 trials were included. The mean differences (MD) in change from baseline in HbA1c of once-weekly semaglutide 1.0 mg versus SGLT-2is ranged from −0.56% for canagliflozin 300 mg (95% credible interval (CrI): −0.76 to −0.33%), to −0.95% for dapagliflozin 5 mg (95% CrI: −1.20 to −0.69%). The MD in change from baseline in weight of once-weekly semaglutide 1.0 mg versus SGLT-2is ranged from −1.35 kg for canagliflozin 300 mg to −2.48 kg for dapagliflozin 5 mg, while change from baseline in fasting plasma glucose ranged from −0.41 mmol/L for canagliflozin 300 mg to −1.37 mmol/L for dapagliflozin 5 mg. Once-weekly semaglutide was not statistically differentiable than all SGLT-2is in reducing systolic blood pressure. NMA was not feasible for postprandial blood glucose and safety outcomes. CONCLUSION: Once-weekly semaglutide demonstrated statistically significant and clinically meaningful reductions in HbA1c and body weight in T2D patients inadequately controlled with 1–2 OADs compared to all SGLT-2is licensed in Europe and North America. |
format | Online Article Text |
id | pubmed-6661926 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-66619262019-08-07 Comparative efficacy of once-weekly semaglutide versus SGLT-2 inhibitors in patients inadequately controlled with one to two oral antidiabetic drugs: a systematic literature review and network meta-analysis Kanters, Steve Wilkinson, Lars Vrazic, Hrvoje Sharma, Rohini Lopes, Sandra Popoff, Evan Druyts, Eric BMJ Open Diabetes and Endocrinology OBJECTIVE: To determine the comparative efficacy of once-weekly semaglutide relative to sodium-glucose cotransporter 2 inhibitors (SGLT-2is) licensed in Europe and North America among patients with type 2 diabetes (T2D) inadequately controlled with 1–2 oral antidiabetics (OADs), using a network meta-analysis (NMA). Design systematic review and network meta-analysis. Data Sources EMBASE, MEDLINE and CENTRAL were searched from January 1994 to August 2017. METHODS: Randomised controlled trials with ≥20 weeks of treatment evaluating once-weekly semaglutide or SGLT-2is. Primary outcomes included change from baseline in: HbA1c, weight, systolic blood pressure, postprandial blood glucose and fasting plasma glucose. Fixed-effect and random-effect Bayesian NMA were used to indirectly compare treatment effects at 26 (±4) weeks. Metaregression and sensitivity analyses were conducted. Model selection was performed using the deviance information criterion and consistency was assessed by comparing indirect (edge-splitting) to direct evidence. RESULTS: Forty-eight publications representing 21 trials were included. The mean differences (MD) in change from baseline in HbA1c of once-weekly semaglutide 1.0 mg versus SGLT-2is ranged from −0.56% for canagliflozin 300 mg (95% credible interval (CrI): −0.76 to −0.33%), to −0.95% for dapagliflozin 5 mg (95% CrI: −1.20 to −0.69%). The MD in change from baseline in weight of once-weekly semaglutide 1.0 mg versus SGLT-2is ranged from −1.35 kg for canagliflozin 300 mg to −2.48 kg for dapagliflozin 5 mg, while change from baseline in fasting plasma glucose ranged from −0.41 mmol/L for canagliflozin 300 mg to −1.37 mmol/L for dapagliflozin 5 mg. Once-weekly semaglutide was not statistically differentiable than all SGLT-2is in reducing systolic blood pressure. NMA was not feasible for postprandial blood glucose and safety outcomes. CONCLUSION: Once-weekly semaglutide demonstrated statistically significant and clinically meaningful reductions in HbA1c and body weight in T2D patients inadequately controlled with 1–2 OADs compared to all SGLT-2is licensed in Europe and North America. BMJ Publishing Group 2019-07-23 /pmc/articles/PMC6661926/ /pubmed/31340953 http://dx.doi.org/10.1136/bmjopen-2018-023458 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Diabetes and Endocrinology Kanters, Steve Wilkinson, Lars Vrazic, Hrvoje Sharma, Rohini Lopes, Sandra Popoff, Evan Druyts, Eric Comparative efficacy of once-weekly semaglutide versus SGLT-2 inhibitors in patients inadequately controlled with one to two oral antidiabetic drugs: a systematic literature review and network meta-analysis |
title | Comparative efficacy of once-weekly semaglutide versus SGLT-2 inhibitors in patients inadequately controlled with one to two oral antidiabetic drugs: a systematic literature review and network meta-analysis |
title_full | Comparative efficacy of once-weekly semaglutide versus SGLT-2 inhibitors in patients inadequately controlled with one to two oral antidiabetic drugs: a systematic literature review and network meta-analysis |
title_fullStr | Comparative efficacy of once-weekly semaglutide versus SGLT-2 inhibitors in patients inadequately controlled with one to two oral antidiabetic drugs: a systematic literature review and network meta-analysis |
title_full_unstemmed | Comparative efficacy of once-weekly semaglutide versus SGLT-2 inhibitors in patients inadequately controlled with one to two oral antidiabetic drugs: a systematic literature review and network meta-analysis |
title_short | Comparative efficacy of once-weekly semaglutide versus SGLT-2 inhibitors in patients inadequately controlled with one to two oral antidiabetic drugs: a systematic literature review and network meta-analysis |
title_sort | comparative efficacy of once-weekly semaglutide versus sglt-2 inhibitors in patients inadequately controlled with one to two oral antidiabetic drugs: a systematic literature review and network meta-analysis |
topic | Diabetes and Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6661926/ https://www.ncbi.nlm.nih.gov/pubmed/31340953 http://dx.doi.org/10.1136/bmjopen-2018-023458 |
work_keys_str_mv | AT kanterssteve comparativeefficacyofonceweeklysemaglutideversussglt2inhibitorsinpatientsinadequatelycontrolledwithonetotwooralantidiabeticdrugsasystematicliteraturereviewandnetworkmetaanalysis AT wilkinsonlars comparativeefficacyofonceweeklysemaglutideversussglt2inhibitorsinpatientsinadequatelycontrolledwithonetotwooralantidiabeticdrugsasystematicliteraturereviewandnetworkmetaanalysis AT vrazichrvoje comparativeefficacyofonceweeklysemaglutideversussglt2inhibitorsinpatientsinadequatelycontrolledwithonetotwooralantidiabeticdrugsasystematicliteraturereviewandnetworkmetaanalysis AT sharmarohini comparativeefficacyofonceweeklysemaglutideversussglt2inhibitorsinpatientsinadequatelycontrolledwithonetotwooralantidiabeticdrugsasystematicliteraturereviewandnetworkmetaanalysis AT lopessandra comparativeefficacyofonceweeklysemaglutideversussglt2inhibitorsinpatientsinadequatelycontrolledwithonetotwooralantidiabeticdrugsasystematicliteraturereviewandnetworkmetaanalysis AT popoffevan comparativeefficacyofonceweeklysemaglutideversussglt2inhibitorsinpatientsinadequatelycontrolledwithonetotwooralantidiabeticdrugsasystematicliteraturereviewandnetworkmetaanalysis AT druytseric comparativeefficacyofonceweeklysemaglutideversussglt2inhibitorsinpatientsinadequatelycontrolledwithonetotwooralantidiabeticdrugsasystematicliteraturereviewandnetworkmetaanalysis |