关键词:

心血管事件, SGLT2抑制剂, 非奈利酮, 2型糖尿病, 慢性肾脏病, 网状荟萃分析

Abstract:

Objective　To compare the effects of finerenone versus sodium-glucose cotransporter protein-2 (SGLT2) inhibitors on cardiovascular events in patients with type 2 diabetes mellitus and/or chronic kidney disease. Methods　The PubMed, Cochrane Library, Web of Science, and Embase databases were searched for the randomized controlled trials on patients with type 2 diabetes mellitus and/or chronic kidney disease from their establishment to July 3,2023. This network meta-analysis (NMA) was performed using the STATA 17.0 software based on the frequency models. Results　A total of 7 randomized controlled trials were included, including 33 206 patients. The treatments included finerenone and SGLT2 inhibitors; the SGLT2 inhibitors included empagliflozin, canagliflozin, dapagliflozin, and sotagliflozin (a dual SGLT inhibitor). In terms of cardiovascular composite events, sotagliflozin was the most effective according to the surface under the cumulative ranking area (SUCRA) ranking. In terms of cardiovascular deaths, empagliflozin was the most effective according to the SUCRA ranking. In terms of hospitalization for heart failure, canagliflozin was the most effective according to the SUCRA ranking. In terms of all-cause mortality, dapagliflozin was the most effective according to the SUCRA ranking. There were no statistical differences between finerenone and SGLT2 inhibitors in terms of safety of adverse events, serious adverse events, and acute kidney damage. For patients with hyperkalemia, SGLT2 inhibitors had a lower incidence than finerenone (RR=0.41, 95%CI 0.32～0.52). Conclusion　SGLT2 inhibitors reduce the incidence of cardiovascular events better than finerenone and can be used as basic treatment for patients with type 2 diabetes mellitus and/or chronic kidney disease and help prevent or reduce cardiovascular events.

Key words:

Cardiovascular events, SGLT2 inhibitors, Finerenone, Type 2 diabetes mellitus, Chronic kidney disease, Network meta-analysis