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Assessing the Effects of Modern Renoprotective Agents in Preventing Progression of Renal Composite Outcomes in Patients with Type 2 Diabetes: A Network Meta-analysis

BACKGROUND AND AIMS: Type 2 diabetes is one of the leading causes of the development and progression of diabetic kidney disease, culminating in end-stage renal disease. Approximately two decades after successful implementation of the renin–angiotensin–aldosterone blocking system, three classes of ag...

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Autores principales: Ghosal, Samit, Sinha, Binayak
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9943809/
https://www.ncbi.nlm.nih.gov/pubmed/36566447
http://dx.doi.org/10.1007/s13300-022-01359-0
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author Ghosal, Samit
Sinha, Binayak
author_facet Ghosal, Samit
Sinha, Binayak
author_sort Ghosal, Samit
collection PubMed
description BACKGROUND AND AIMS: Type 2 diabetes is one of the leading causes of the development and progression of diabetic kidney disease, culminating in end-stage renal disease. Approximately two decades after successful implementation of the renin–angiotensin–aldosterone blocking system, three classes of agents [sodium glucose cotransporter 2 inhibitors (SGLT-2i), glucagon-like peptide 1 receptor agonists, and nonsteroidal mineralocorticoid receptor antagonists] have shown significant potential to confer renoprotection. This network meta-analysis was undertaken to construct a hierarchy based on indirect pairwise comparisons and rankings among and within these three classes of molecules. METHODS: A Cochrane library-based web search yielded 16 randomized controlled trials for analysis. Stata/BE 17.0 and RStudio 2022.07.1 Build 554 software were used to conduct a frequentist network meta-analysis. The effect size was assessed based on the odds ratio, and the MDS (multidimensional scaling) rank system was used to identify a hierarchy among reno-protective molecules. RESULTS: Regarding the overall data, the SGLT-2i group of agents ranked higher than the other groups in preventing the progression of renal composite events in patients with T2D. Dapagliflozin ranked the highest among individual molecules. CONCLUSIONS: The SGLT-2i group of agents, especially dapagliflozin, is best suited to complement metabolic control in preventing the progression of renal composite outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13300-022-01359-0.
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spelling pubmed-99438092023-02-23 Assessing the Effects of Modern Renoprotective Agents in Preventing Progression of Renal Composite Outcomes in Patients with Type 2 Diabetes: A Network Meta-analysis Ghosal, Samit Sinha, Binayak Diabetes Ther Original Research BACKGROUND AND AIMS: Type 2 diabetes is one of the leading causes of the development and progression of diabetic kidney disease, culminating in end-stage renal disease. Approximately two decades after successful implementation of the renin–angiotensin–aldosterone blocking system, three classes of agents [sodium glucose cotransporter 2 inhibitors (SGLT-2i), glucagon-like peptide 1 receptor agonists, and nonsteroidal mineralocorticoid receptor antagonists] have shown significant potential to confer renoprotection. This network meta-analysis was undertaken to construct a hierarchy based on indirect pairwise comparisons and rankings among and within these three classes of molecules. METHODS: A Cochrane library-based web search yielded 16 randomized controlled trials for analysis. Stata/BE 17.0 and RStudio 2022.07.1 Build 554 software were used to conduct a frequentist network meta-analysis. The effect size was assessed based on the odds ratio, and the MDS (multidimensional scaling) rank system was used to identify a hierarchy among reno-protective molecules. RESULTS: Regarding the overall data, the SGLT-2i group of agents ranked higher than the other groups in preventing the progression of renal composite events in patients with T2D. Dapagliflozin ranked the highest among individual molecules. CONCLUSIONS: The SGLT-2i group of agents, especially dapagliflozin, is best suited to complement metabolic control in preventing the progression of renal composite outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13300-022-01359-0. Springer Healthcare 2022-12-25 2023-02 /pmc/articles/PMC9943809/ /pubmed/36566447 http://dx.doi.org/10.1007/s13300-022-01359-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Ghosal, Samit
Sinha, Binayak
Assessing the Effects of Modern Renoprotective Agents in Preventing Progression of Renal Composite Outcomes in Patients with Type 2 Diabetes: A Network Meta-analysis
title Assessing the Effects of Modern Renoprotective Agents in Preventing Progression of Renal Composite Outcomes in Patients with Type 2 Diabetes: A Network Meta-analysis
title_full Assessing the Effects of Modern Renoprotective Agents in Preventing Progression of Renal Composite Outcomes in Patients with Type 2 Diabetes: A Network Meta-analysis
title_fullStr Assessing the Effects of Modern Renoprotective Agents in Preventing Progression of Renal Composite Outcomes in Patients with Type 2 Diabetes: A Network Meta-analysis
title_full_unstemmed Assessing the Effects of Modern Renoprotective Agents in Preventing Progression of Renal Composite Outcomes in Patients with Type 2 Diabetes: A Network Meta-analysis
title_short Assessing the Effects of Modern Renoprotective Agents in Preventing Progression of Renal Composite Outcomes in Patients with Type 2 Diabetes: A Network Meta-analysis
title_sort assessing the effects of modern renoprotective agents in preventing progression of renal composite outcomes in patients with type 2 diabetes: a network meta-analysis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9943809/
https://www.ncbi.nlm.nih.gov/pubmed/36566447
http://dx.doi.org/10.1007/s13300-022-01359-0
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