Risk of gastrointestinal reactions related to sodium-glucose transporter 2 inhibitors: a network meta-analysis
10.3760/cma.j.cn114015-20230605-00406
- VernacularTitle:钠-葡萄糖转运蛋白2抑制剂相关胃肠道反应风险的网状meta分析
- Author:
Juan LING
1
;
Yan JIANG
;
Zhuolin XIE
;
Hongting ZHAO
;
Xiangxia LUO
Author Information
1. 甘肃中医药大学中医临床学院，兰州 730030
- Publication Type:Journal Article
- Keywords:
Diabetes mellitus, type 2;
Sodium-glucose transporter 2 inhibitors;
Gastrointestinal diseases;
Network meta-analysis;
Drug-related side effects and advers
- From:
Adverse Drug Reactions Journal
2023;25(12):739-747
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To systematically evaluate the risks of gastrointestinal reactions induced by sodium-glucose transporter 2 (SGLT2) inhibitors in patients with type 2 diabetes mellitus.Methods:Randomized controlled trials of SGLT2 inhibitors in the treatment of type 2 diabetes mellitus, in which gastrointestinal reactions were evaluated as one of outcome indicators, were collected by searching relevant databases at home and abroad (up to December 30, 2022). Cochrane risk of bias assessment tool was used to evaluate the quality of the included studies. Stata 15.1 software was used to conduct Bayesian network meta-analysis, including drawing the network evidence plot, the league map of pairwise comparison, and the surface under the cumulative ranking curve (SUCRA) for gastrointestinal reaction risks with different interventions of SGLT2 inhibitors, and ranking the risks of gastrointestinal reaction of different interventions of SGLT2 inhibitors. The effect sizes of gastrointestinal reaction were expressed by relative risk ( RR) and its 95% confidence interval ( CI). Results:A total of 15 studies were included in the analysis, involving 5 540 patients with 3 949 in the SGLT2 inhibitor treatment group and 1 591 in the control group. Drugs that used in the treatment group included dapagliflozin (in 1 872 patients), canagliflozin (in 1 100 patients), empagliflozin (in 649 patients), ertugliflozin (in 219 patients), ipragliflozin (in 61 patients), and licogliflozin (in 48 patients). All patients in the control group were treated with placebo. The results of the network meta-analysis showed that the risk of gastrointestinal reactions was higher after treatment with 10 mg of ertugliflozin, compared with those with 50 mg and 100 mg of canagliflozin ( RR=1.37, 95% CI: 1.02-3.48; RR=2.98, 95% CI: 1.19-4.09; all P<0.05). There was no statistically significant difference in comparison between other interventions with SGLT2 inhibitors. According to the results of SUCRA on the relative risks for gastrointestinal reactions of different interventions with SGLT2 inhibitors, interventions were ranked as licogliflozin 50 mg, ertugliflozin 25 mg, ertugliflozin 10 mg, empagliflozin 25 mg, ipragliflozin 100 mg, ipragliflozin 300 mg, ipragliflozin 200 mg, ertugliflozin 5 mg, licogliflozin 10 mg, ipragliflozin 50 mg, empagliflozin 10 mg, licogliflozin 2.5 mg, dapagliflozin 20 mg, dapagliflozin 10 mg, empagliflozin 5 mg, ertugliflozin 1 mg, dapagliflozin 5 mg, placebo, canagliflozin 300 mg, canagliflozin 200 mg, dapagliflozin 2.5 mg, dapagliflozin 1 mg, canagliflozin 100 mg, canagliflozin 50 mg. Conclusions:Different SGLT2 inhibitor treatment regimens lead to different risks of gastrointestinal reactions in patients with type 2 diabetes. The risk of gastrointestinal reactions caused by canagliflozin is low, especially under the dose of 50 mg. Licogliflozin and ertugliflozin have greater possibility to cause gastrointestinal reactions, especially when they were used at high doses.
