doi:10.1007/s40620-023-01858-8...
Springer
Urology
2024
1/24/2024
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 m^2.
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
Brockmeyer, Maximilian,Parco, Claudio,Vargas, Kris Gregory,Westenfeld, Ralf,Jung, Christian,Kelm, Malte,Roden, Michael,Akbulut, Cihan,Schlesinger, Sabrina,Wolff, Georg,Kuss, Oliver, 2024, Absolute treatment effects of novel antidiabetic drugs on a composite renal outcome: meta-analysis of digitalized individual patient data, Springer