Evidence mapPaperPMID 29564723Full record

SynthesisClinical drug investigation2018

Cardiovascular Mortality of Oral Antidiabetic Drugs Approved Before and After the 2008 US FDA Guidance for Industry: A Systemic Review and Meta-Analysis.

Rashmi Goyat, Pragya Rai, Jongwha Chang, Charles D Ponte, Xi Tan

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Clinical drug investigation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 38% 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.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · 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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Anti-atherosclerotic effect of incretin mimetics: a meta-analysis of randomized controlled trials.Journal of community hospital internal medicine perspectives · 2018
    Review
4 · The record

Corrections and comments

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

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Rashmi GoyatDepartment of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, 26506, USA.
Pragya RaiDepartment of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, 26506, USA.
Jongwha ChangDepartment of Pharmacy Practice, School of Pharmacy, University of Texas, El Paso, TX, 79968, USA.
Charles D PonteDepartment of Clinical Pharmacy, School of Pharmacy, West Virginia University, Morgantown, WV, 26506, USA.
Xi TanDepartment of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, 26506, USA. xntan@hsc.wvu.edu.ORCID http://orcid.org/0000-0002-2409-5927
West Virginia University · USThe University of Texas at El Paso · US

Funding

West Virginia Clinical and Translational Science Institute: A Statewide Organization Building Research Excellence and Engaging Communities to Improve HealthU54GM104942 · WEST VIRGINIA UNIVERSITY · 2025 to 2025
$4.0M
NIGMS NIH HHS U54 GM104942
6 · The paper itself

Abstract

backgroundBoth diabetes and antidiabetic drugs (ADDs) increase the risk for cardiovascular (CV) diseases. Due to the increasing concern about CV safety associated with ADDs, the US FDA revised regulatory guidelines in 2008 to include CV safety as an endpoint.

objectiveThe objective of the current study was to conduct a systematic review with meta-analysis to compare CV mortality of oral ADDs approved before and after the FDA's 2008 guidance.

methodsThree electronic databases (PubMed, Scopus, and the Clinical Trial Registry) were searched to retrieve studies published up to 24 February 2017. Randomized clinical trials were included in this study if they (1) were published in the English language; (2) included adults with type 2 diabetes mellitus with or without CV risk factors, who were taking at least one oral antidiabetic drug; and (3) had at least one study outcome as CV mortality. Meta-analysis was performed using a random-effects model. Small-study effects were accessed using funnel plot symmetry. The primary outcome was CV mortality.

resultsWe found that there was no significant increase in CV mortality for drugs approved before and after 2008. The overall odds ratio (OR) and the upper bound of the two-sided 95% confidence interval (CI) for all drugs approved after 2008 (OR 0.74, 95% CI 0.52-1.07) were lower than the overall OR for all drugs approved before 2008 (OR 1.03, 95% CI 0.89-1.19). In addition, the upper bounds of the two-sided 95% CI for both groups of drugs before and after 2008 were below 1.3. Empagliflozin, which was approved after the guidance, was significantly associated with a reduction in CV mortality.

conclusionThe 2008 FDA guidance appears to have a positive impact on CV risk assessment of recently marketed drugs for the management of diabetes.

Indexed as

AdultBenzhydryl CompoundsCardiovascular DiseasesDiabetes Mellitus, Type 2GlucosidesHumansHypoglycemic AgentsRandomized Controlled Trials as TopicRiskUnited StatesUnited States Food and Drug AdministrationBenzhydryl CompoundsempagliflozinGlucosidesHypoglycemic Agents

Identifiers

PMID29564723
PMCPMC5953843
OpenAlexW2793394235

What Socratic holds

Textmetadata
LicenceTDM
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.