We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Cardiovascular events and all-cause mortality associated with sulphonylureas compared with other antihyperglycaemic drugs: A Bayesian meta-analysis of survival data.
- Authors
Bain, Steve; Druyts, Eric; Balijepalli, Chakrapani; Baxter, Carl A.; Currie, Craig J.; Das, Romita; Donnelly, Richard; Khunti, Kamlesh; Langerman, Haya; Leigh, Paul; Siliman, Gaye; Thorlund, Kristian; Toor, Kabirraaj; Vora, Jiten; Mills, Edward J.
- Abstract
Aim To conduct a systematic review and meta-analysis to determine the risk of cardiovascular events and all-cause mortality associated with sulphonylureas ( SUs) vs other glucose lowering drugs in patients with T2DM ( T2DM). Materials and methods A systematic review of Medline, Embase, Cochrane and was conducted for studies comparing SUs with placebo or other antihyperglycaemic drugs in patients with T2DM. A cloglog model was used in the Bayesian framework to obtain comparative hazard ratios ( HRs) for the different interventions. For the analysis of observational data, conventional fixed-effect pairwise meta-analyses were used. Results The systematic review identified 82 randomized controlled trials ( RCTs) and 26 observational studies. Meta-analyses of RCT data showed an increased risk of all-cause mortality and cardiovascular-related mortality for SUs compared with all other treatments combined ( HR 1.26, 95% confidence interval [ CI] 1.10-1.44 and HR 1.46, 95% CI 1.21-1.77, respectively). The risk of myocardial infarction was significantly higher for SUs compared with dipeptidyl peptidase-4 ( DPP-4) inhibitors and sodium-glucose co-transporter-2 inhibitors ( HR 2.54, 95% CI 1.14-6.57 and HR 41.80, 95% CI 1.64-360.4, respectively). The risk of stroke was significantly higher for SUs than for DPP-4 inhibitors, glucagon-like peptide-1 agonists, thiazolidinediones and insulin. Conclusions The present meta-analysis showed an association between SU therapy and a higher risk of major cardiovascular disease-related events compared with other glucose lowering drugs. Results of ongoing RCTs, which should be available in 2018, will provide definitive results on the risk of cardiovascular events and all-cause mortality associated with SUs vs other antihyperglycaemic drugs.
- Subjects
PHYSIOLOGICAL effects of glucose; PEOPLE with diabetes; CARDIOVASCULAR diseases risk factors; RANDOMIZED controlled trials; META-analysis
- Publication
Diabetes, Obesity & Metabolism, 2017, Vol 19, Issue 3, p329
- ISSN
1462-8902
- Publication type
Article
- DOI
10.1111/dom.12821