Evidence map›SGLT2 inhibitors × adverse events & safety›PMID 25124541›Full record

SynthesisEuropean journal of clinical pharmacology2014

Efficacy and safety of canagliflozin in subjects with type 2 diabetes: systematic review and meta-analysis.

Xu-Ping Yang, Dan Lai, Xiao-Yan Zhong, Hong-Ping Shen, Yi-Lan Huang

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of clinical pharmacology, 2014. The graph read 3 numbers from its abstract, feeding 2 cells of the map: it supports the treatment in 1, favours the comparator in 1. Cited by 53 papers, 10 of them syntheses that pooled it.

3numbers the graph read from it
2cells of the map it votes in
53citing papers in PubMed, 10 pooled it
13.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

← favours the treatmentfavours the comparator →
0.10.250.524101 · no effect
Adverse events & safetyfavours the comparator · against placebo · t2dfeeds one cell of the map
RR 4.953.25 to 7.52
Genital tract infections were more common with canagliflozin (vs. placebo, RR 3.76, 95%CI [2.23 to 6.35]; vs. active comparators, RR 4.95, 95%CI [3.25 to 7.52]).
FeedsSGLT2 inhibitors×adverse events & safety
Hypoglycaemiafavours the treatment · against placebo · t2dfeeds one cell of the map
RR 0.150.10 to 0.22
Hypoglycemia with canagliflozin was similar to placebo or sitagliptin, and was lower than glimepiride (risk ratio (RR) 0.15, 95%CI [0.10 to 0.22]).
FeedsSulfonylureas & glinides×hypoglycaemia
Adverse events & safetyfavours the comparator · against placebo · t2dfeeds one cell of the map
RR 3.762.23 to 6.35
Genital tract infections were more common with canagliflozin (vs. placebo, RR 3.76, 95%CI [2.23 to 6.35]; vs. active comparators, RR 4.95, 95%CI [3.25 to 7.52]).
FeedsSGLT2 inhibitors×adverse events & safety

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

SGLT2 inhibitors×adverse events & safety

SupportsOpen on the map →What to test next →

38 readable studies in this cell: 18 favour the treatment, 19 find no difference, 1 favour the comparator.

Belief with this paper
0.00contested · 0 families support, 26 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT011374742,996 enrolled · 2010
Δ -0.46-0.59 to -0.33
NCT017190031,413 enrolled · 2012
Adjusted mean -0.33-0.56 to -0.10
NCT020991101,233 enrolled · 2014
Δ 1.40-7.40 to 10.1
NCT018093271,186 enrolled · 2013
Δ -0.46-0.66 to -0.27
NCT01649297983 enrolled · 2012
Δ -0.61-0.79 to -0.44
NCT02580591977 enrolled · 2015
Δ -0.28-0.46 to -0.11
NCT02414958730 enrolled · 2015
Δ -0.54-0.66 to -0.41
NCT01381900678 enrolled · 2011
Δ -0.51-0.64 to -0.37
NCT02033889621 enrolled · 2013
Δ 1.50-2.10 to 5.40
NCT02532855614 enrolled · 2015
Δ -2.80-10.7 to 5.10
NCT02630706506 enrolled · 2015
Δ -6.00-16.5 to 4.60
NCT02036515464 enrolled · 2014
Δ -5.70-16.5 to 5.20

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

Sulfonylureas & glinides×hypoglycaemia

ContradictsOpen on the map →What to test next →

10 readable studies in this cell: 0 favour the treatment, 1 find no difference, 9 favour the comparator.

Belief with this paper
0.50one trial · 1 family supports, 0 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the comparatorfavours the treatment →
0 · no effect
NCT017093055,570 enrolled · 2012
Estimate -8.40-11.1 to -6.10
NCT006609071,217 enrolled · 2008
Δ -37.2-42.3 to -32.2
NCT03332771954 enrolled · 2017
Δ -15.4-19.7 to -11.1
NCT02471404939 enrolled · 2015
Δ -4.21-6.45 to -1.97
NCT00575588891 enrolled · 2007
Δ -33.2-38.1 to -28.5
NCT01682759751 enrolled · 2012
Δ -21.3-26.5 to -16.4
NCT00792935143 enrolled · 2009
Proportions -7.70-23.6 to 8.70

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

53 citing papers in PubMed, 10 syntheses or guidelines pooled it, 129 citations in OpenAlex.

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  11. Article
  12. Review
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6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Xu-Ping YangDepartment of Pharmacy, The TCM Hospital Affiliated to Luzhou Medical College, Luzhou, 646000, Sichuan Province, People's Republic of China, lzyxyyxp123@163.com.
Dan Lai
Xiao-Yan Zhong
Hong-Ping Shen
Yi-Lan Huang
Southwest Medical University · CNFirst Affiliated Hospital of Sichuan Medical University · CNHua Medicine (China) · CN

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

purposeTo assess the efficacy and safety of the novel sodium glucose co-transporter 2 (SGLT2) inhibitor-canagliflozin for type 2 diabetes (T2DM).

methodsA search of Medline (1946-January 2014), Embase (1950-January 2014), and The Cochrane Library for randomized controlled trials of canagliflozin compared to placebo or active comparator in T2DM was performed. Clinical Trials website and unpublished U.S. Food and Drug Administration data were also searched.

resultsTen trials including 6,701 patients were analyzed. Compared with placebo, canagliflozin produced absolute reductions in glycated hemoglobin A1c levels when used as monotherapy (weighted mean difference (WMD) -1.08%, 95% confidence interval (CI) [-1.25 to -0.90], p < 0.00001) or add-on treatment (WMD -0.73%, 95%CI [-0.84 to -0.61], p < 0.00001). When compared with other active comparators, canagliflozin significantly reduced HbA1c by -0.21% (WMD, 95%CI [-0.33 to -0.08], p = 0.001). Canagliflozin led to greater body weight loss (vs. placebo, WMD -2.81 kg, 95%CI [-3.26 to -2.37]; vs. active comparators, WMD -3.49 kg, 95%CI [-4.86 to -2.12]). Hypoglycemia with canagliflozin was similar to placebo or sitagliptin, and was lower than glimepiride (risk ratio (RR) 0.15, 95%CI [0.10 to 0.22]). Genital tract infections were more common with canagliflozin (vs. placebo, RR 3.76, 95%CI [2.23 to 6.35]; vs. active comparators, RR 4.95, 95%CI [3.25 to 7.52]). Similar incidences of urinary tract infections were noted with canagliflozin compared with control groups.

conclusionCanagliflozin led to improvements in reducing glycated hemoglobin A1c levels and body weight with low risk of hypoglycemia in patients with T2DM. Common adverse effects including genital tract infections and osmotic diuresis-related AEs were identified and reviewed. Risks of cardiovascular events are even less certain, and more data on long-term effects are needed.

Indexed as

CanagliflozinDiabetes Mellitus, Type 2GlucosidesGlycated HemoglobinHumansHypoglycemiaHypoglycemic AgentsSodium-Glucose Transporter 2 InhibitorsThiophenesCanagliflozinGlucosidesGlycated HemoglobinHypoglycemic AgentsSodium-Glucose Transporter 2 InhibitorsThiophenes

Identifiers

PMID25124541
OpenAlexW1995006519

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.