Comparison of Type 2 Diabetes Treatments in Improving Survival

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, APRIL 17, 2018

Media advisory: To contact corresponding author Sean L. Zheng, B.M., B.Ch., M.A., M.R.C.P., email sean.zheng@nhs.net. The full study is available on the For The Media website.

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Translation available: A translation in simplified Chinese is available below.

 

Bottom Line: In a comparison of different classes of drugs used to lower blood sugar levels for patients with type 2 diabetes, sodium-glucose cotransporter 2 (SGLT-2) inhibitors or glucagon-like peptide 1(GLP-1) agonists were associated with a lower risk of death than dipeptidyl peptidase 4 (DPP-4) inhibitors or control (placebo or no treatment).

Why The Research Is Interesting: Several drug classes have emerged that are effective in improving blood sugar control for patients with type 2 diabetes, including SGLT-2 and DPP-4 inhibitors and GLP-1 agonists. The clinical effectiveness of these drugs compared to each other is not known.

Who and When: 176,310 study participants with type 2 diabetes in 236 randomized clinical trials in databases through October 2017

What (Study Measures): SGLT-2 inhibitors, GLP-1 agonists, DPP-4 inhibitors, and control (placebo, no treatment) (interventions); death from any cause (outcome).

How (Study Design): This was a network meta-analysis, which combines the results of multiple studies identified in a systematic review and quantitatively summarizes the overall association between interventions and outcomes measured across all studies.

Authors: Sean L. Zheng, B.M., B.Ch., M.A., M.R.C.P., Imperial College Healthcare NHS Foundation Trust, London, and coauthors

Results:

Study Limitations: Network meta-analysis respects randomization of clinical trials, but itself represents observational data, preventing conclusions on causality from being inferred.

Study Conclusions: In patients with type 2 diabetes, the use of SGLT-2 inhibitors or GLP-1 agonists was associated with better survival than DPP-4 inhibitors.

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(doi:10.1001/jama.2018.3024)

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Translation in Simplified Chinese

禁止提前报道指令解除时间:2018417 星期二,美国东部时间上午11

 

媒体咨询:联系通讯作者Sean L. Zheng, B.M., B.Ch., M.A., M.R.C.P,请发电子邮件到sean.zheng@nhs.net

 

2型糖尿病不同治疗在改善生存率上的比较

 

概要: 根据《美国医学会杂志》(JAMA)发表的一项研究,对能降低2型糖尿病患者的血糖水平的不同类别药物的比较显示,与二肽基肽酶4(DPP-4)抑制剂或对照组(安慰剂或不治疗)相比,钠 – 葡萄糖协同转运蛋白2(SGLT-2)抑制剂或胰高血糖素样肽1(GLP-1)激动剂会导致死亡风险的降低。

 

为何对该问题感兴趣:目前已经出现了几种能够有效改善2型糖尿病患者的血糖控制的药物类别,包括SGLT-2和DPP-4抑制剂以及GLP-1激动剂。 但尚不清楚这些药物的临床效果的相互比较。

 

研究参与者及时间:到2017年10月,共有176,310名2型糖尿病患者参与了数据库中的236项随机临床试验

 

研究什么(研究内容):SGLT-2抑制剂,GLP-1激动剂,DPP-4抑制剂和对照(安慰剂,不治疗)(干预); 任何原因造成的死亡(结果)。

 

如何研究(研究设计):这是一项网络元分析,它结合了系统评价中确定的多项研究的结果,并定量总结了所有研究中测量的干预措施与结局之间的整体关联。

 

研究结果:

  • 与DPP-4抑制剂或对照组(安慰剂或不治疗)相比,SGLT-2抑制剂或GLP-1激动剂会导致死亡风险的降低。
  • 与安慰剂或不治疗相比,DPP-4抑制剂不会导致死亡风险的降低。

 

研究局限:网络元分析尊重临床试验的随机化,但它本身代表了观察性数据,从而无法得出具有因果关系的结论。

 

研究结论:与DPP-4抑制剂相比, 2型糖尿病患者使用SGLT-2抑制剂或GLP-1激动剂会导致更高的生存率。

 

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