This systematic and meta-analysis aims to evaluate humoral and cellular responses to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine among kidney transplant recipients (KTRs). We conducted a systematic literature search across databases to evaluate seroconversion and cellular response rates in KTRs receiving SARS-CoV-2 vaccines. We extracted studies that assessed seroconversion rates described as the presence of antibody de novo positivity in KTRs following SARS-CoV-2 vaccination published up to January 23rd, 2022. We also performed meta-regression based on immunosuppression therapy used. A total of 44 studies involving 5,892 KTRs were included in this meta-analysis. The overall seroconversion rate following complete dose of vaccines was 39.2% (95% confidence interval [CI], 33.3%–45.3%) and cellular response rate was 41.6% (95% CI, 30.0%–53.6%). Meta-regression revealed that low antibody response rate was significantly associated with the high prevalence of mycophenolate mofetil/mycophenolic acid (p=0.04), belatacept (p=0.02), and anti-CD25 induction therapy uses (p=0.04). Conversely, tacrolimus use was associated with higher antibody response (p=0.01). This meta-analysis suggests that postvaccination seroconversion and cellular response rates in KTRs are still low. And seroconversion rate was correlated with the type of immunosuppressive agent and induction therapy used. Additional doses of the SARS-CoV-2 vaccine for this population using a different type of vaccine are considered.

Introduction: Sodium glucose transporter 2 (SGLT2) inhibitors are a new class of anti-diabetic agents that not only lower down blood sugar but can potentially cause weight loss and decrease in blood pressure. The aim of this meta-analysis is to evaluate the magnitude of changes in blood pressure and safety parameters with the use of SGLT2 inhibitors among adult patients with type 2 diabetes mellitus (DM). Methods: Randomized controlled trials (RCTs) were retrieved from electronic databases. We used the method recommend by the Cochrane Collaboration to perform a meta-analysis of RCTs of SGLT2 inhibitor for type 2 DM. Results: Of 137 studies retrieved in the literature search, 28 were eligible for inclusion. A total of 23,728 patients with average age of 50-63 years old, when SGLT2 inhibitor were compared with placebo or active comparators there were statistically significant reduction in systolic (MD: -4.01, 95% CI -4.03 to -3.99) and diastolic blood pressure (MD: -1.48, 95% CI -1.49 to -1.46). There were no significant differences in the incidence of hypoglycemia (RR: 0.94, 95% CI 0.90 to 0.99, P<0.00001) between SGLT2 inhibitors and control groups. The incidence of urinary tract infections was similar between the SGLT2 inhibitors and the control groups (RR: 1.12, 95% CI 1.01 to 1.25, P=1.00). There was statistically greater incidence of orthostatic hypotension among patients given SGLT2 inhibitors than the control group (RR: 1.41, 95% CI 1.14 to 1.75, P=0.99). Conclusion Treatment with SGLT2 inhibitor provided statistically significant reductions in systolic and diastolic blood pressure in patients with type 2 DM compared with placebo or other anti-diabetic agents.
Blood Pressure ; Sodium-Glucose Transporter 2 Inhibitors ; Diabetes Mellitus, Type 2