Cochrane · systematic review · CD013650
Dipeptidyl peptidase‐4 inhibitors, glucagon‐like peptide 1 receptor agonists and sodium‐glucose co‐transporter‐2 inhibitors for people with cardiovascular disease: a network meta‐analysis
Kanie, T, Mizuno, A, Takaoka, Y, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
27
current version
GRADE rated
26
No studies
1
Included studies
NR
No studies 1 · 3.7%Ungraded 0 · 0%Very low 0 · 0%Low 5 · 18.5%Moderate 10 · 37%High 11 · 40.7%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
DPP4i compared to placebo in people with CVD: efficacy outcomes
Population: CVD (ASCVD, HF, or both)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cardiovascular mortality DPP4i vs placebo | OR 1 [0.91, 1.09] | 6 studies · 47968 participants | High |
Myocardial infarction (fatal or non‐fatal) DPP4i vs placebo | OR 0.97 [0.88, 1.08] | 4 studies · 42334 participants | High |
Stroke (fatal or non‐fatal) DPP4i vs placebo | OR 1 [0.87, 1.14] | 5 studies · 42588 participants | High |
All‐cause mortality DPP4i vs placebo | OR 1.03 [0.96, 1.11] | 6 studies · 47968 participants | High |
Hospitalisation for HF DPP4i vs placebo | OR 0.99 [0.8, 1.23] | 4 studies · 42334 participants | Moderate Downgraded: inconsistency |
DPP4i compared to placebo in people with CVD: safety outcomes
Population: CVD (ASCVD, HF, or both)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Worsening renal function DPP4i vs placebo | OR 1.08 [0.88, 1.33] | 1 study · 16492 participants | Low Downgraded: imprecision |
Hypoglycaemia DPP4i vs placebo | OR 1.11 [0.95, 1.29] | 3 studies · 25842 participants | Moderate Downgraded: imprecision |
Pancreatitis DPP4i vs placebo | OR 1.63 [1.12, 2.37] | 5 studies · 47684 participants | Moderate Downgraded: imprecision |
Fracture DPP4i vs placebo | OR 1 [0.83, 1.19] | 1 study · 16492 participants | Moderate Downgraded: imprecision |
GLP‐1RA compared to placebo in people with CVD: efficacy outcomes
Population: CVD (ASCVD, HF, or both)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cardiovascular mortality GLP‐1RA vs placebo | OR 0.87 [0.79, 0.95] | 6 studies · 46093 participants | High |
Myocardial infarction (fatal or non‐fatal) GLP‐1RA vs placebo | OR 0.89 [0.78, 1.01] | 5 studies · 42910 participants | Moderate Downgraded: inconsistency |
Stroke (fatal or non‐fatal) GLP‐1RA vs placebo | OR 0.87 [0.77, 0.98] | 5 studies · 42910 participants | High |
All‐cause mortality GLP‐1RA vs placebo | OR 0.88 [0.82, 0.95] | 7 studies · 46393 participants | High |
Hospitalisation for HF GLP‐1RA vs placebo | OR 0.95 [0.85, 1.06] | 6 studies · 36930 participants | High |
GLP‐1RA compared to placebo in people with CVD: safety outcomes
Population: CVD (ASCVD, HF, or both)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Worsening renal function GLP‐1RA vs placebo | OR 0.61 [0.44, 0.84] | 1 study · 3297 participants | Low Downgraded: imprecision |
Hypoglycaemia GLP‐1RA vs placebo | no estimate extracted | 5 studies · 37038 participants | Low Downgraded: imprecision, inconsistency |
Pancreatitis GLP‐1RA vs placebo | OR 0.96 [0.68, 1.35] | 5 studies · 40035 participants | Low Downgraded: imprecision, inconsistency |
Fracture GLP‐1RA vs placebo | no estimate extracted | NR | No studies |
SGLT2i compared to placebo in people with CVD: efficacy outcomes
Population: CVD (ASCVD, HF, or both)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cardiovascular mortality SGLT2i vs placebo | OR 0.82 [0.7, 0.95] | 5 studies · 24962 participants | Moderate Downgraded: inconsistency |
Myocardial infarction (fatal or non‐fatal) SGLT2i vs placebo | OR 0.97 [0.84, 1.12] | 2 studies · 15266 participants | High |
Stroke (fatal or non‐fatal) SGLT2i vs placebo | OR 1.12 [0.92, 1.36] | 2 studies · 15266 participants | Moderate Downgraded: imprecision, inconsistency |
All‐cause mortality SGLT2i vs placebo | OR 0.84 [0.74, 0.96] | 5 studies · 24962 participants | Moderate Downgraded: inconsistency |
Hospitalisation for HF SGLT2i vs placebo | OR 0.65 [0.59, 0.71] | 5 studies · 24962 participants | High |
SGLT2i compared to placebo in people with CVD: safety outcomes
Population: CVD (ASCVD, HF, or both)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Worsening renal function SGLT2i vs placebo | OR 0.59 [0.43, 0.82] | 2 studies · 8474 participants | Moderate Downgraded: imprecision |
Hypoglycaemia SGLT2i vs placebo | OR 0.9 [0.75, 1.07] | 4 studies · 21232 participants | Moderate Downgraded: imprecision |
Pancreatitis SGLT2i vs placebo | OR 0.85 [0.39, 1.86] | 1 study · 8246 participants | Low Downgraded: imprecision |
Fracture SGLT2i vs placebo | OR 1.02 [0.88, 1.18] | 5 studies · 24962 participants | High |