Evidence mapPaperPMID 37220263Full record

SynthesisDiabetes care2023

Cardiovascular and Renal Benefits of Novel Diabetes Drugs by Baseline Cardiovascular Risk: A Systematic Review, Meta-analysis, and Meta-regression.

José M Rodriguez-Valadez, Malak Tahsin, Kirsten E Fleischmann, Umesh Masharani, Joseph Yeboah, Meyeon Park, Lihua Li, Ellerie Weber, Yan Li, Asem Berkalieva and 3 more

Open access · bronzeAbstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Diabetes care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 1 pooled it
8.2field-weighted citation impact, top 2% 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

22 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.

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  19. Therapeutic Inertia in the Management of Type 2 Diabetes: A Narrative Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2024
    Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 2 countries.

José M Rodriguez-ValadezInstitute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
Malak TahsinInstitute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
Kirsten E FleischmannDivision of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA.
Umesh MasharaniDepartment of Medicine, University of California, San Francisco, CA.
Joseph YeboahSection of Cardiovascular Medicine, Internal Medicine, Wake Forest University School of Medicine, Winston Salem, NC.
Meyeon ParkDepartment of Medicine, University of California, San Francisco, CA.
Lihua LiInstitute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
Ellerie WeberDepartment of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
Yan LiDepartment of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
Asem BerkalievaInstitute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
Wendy MaxInstitute for Health & Aging and Department of Social and Behavioral Sciences, University of California, San Francisco, CA.
M G Myriam HuninkDepartments of Epidemiology and Radiology, Erasmus MC, Rotterdam, the Netherlands.
Bart S FerketInstitute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.ORCID 0000-0003-2754-545X
Icahn School of Medicine at Mount Sinai · USUniversity of California, San Francisco · USErasmus MC · NLWake Forest University · US

Funding

New York Regional Center for Diabetes Translation ResearchP30DK111022 · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2025 to 2025
$810k
NHLBI NIH HHS R01 HL153456NIDDK NIH HHS P30 DK111022
6 · The paper itself

Abstract

backgroundEligibility for glucagon-like peptide 1 receptor agonists (GLP-1RA) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) has been expanded to patients with diabetes at lower cardiovascular risk, but whether treatment benefits differ by risk levels is not clear. PURPOSE: To investigate whether patients with varying risks differ in cardiovascular and renal benefits from GLP-1RA and SGLT2i with use of meta-analysis and meta-regression. DATA SOURCES: We performed a systematic review using PubMed through 7 November 2022. STUDY SELECTION: We included reports of GLP-1RA and SGLT2i confirmatory randomized trials in adult patients with safety or efficacy end point data. DATA EXTRACTION: Hazard ratio (HR) and event rate data were extracted for mortality, cardiovascular, and renal outcomes. DATA SYNTHESIS: We analyzed 9 GLP-1RA and 13 SGLT2i trials comprising 154,649 patients. Summary HRs were significant for cardiovascular mortality (GLP-1RA 0.87 and SGLT2i 0.86), major adverse cardiovascular events (0.87 and 0.88), heart failure (0.89 and 0.70), and renal (0.84 and 0.65) outcomes. For stroke, efficacy was significant for GLP-1RA (0.84) but not for SGLT2i (0.92). Associations between control arm cardiovascular mortality rates and HRs were nonsignificant. Five-year absolute risk reductions (0.80-4.25%) increased to 11.6% for heart failure in SGLT2i trials in patients with high risk (Pslope < 0.001). For GLP1-RAs, associations were nonsignificant. LIMITATIONS: Analyses were limited by lack of patient-level data, consistency in end point definitions, and variation in cardiovascular mortality rates for GLP-1RA trials.

conclusionsRelative effects of novel diabetes drugs are preserved across baseline cardiovascular risk, whereas absolute benefits increase at higher risks, particularly regarding heart failure. Our findings suggest a need for baseline risk assessment tools to identify variation in absolute treatment benefits and improve decision-making.

Indexed as

Cardiovascular DiseasesCardiovascular SystemDiabetes MellitusHeart FailureAdultHeart Disease Risk FactorsHumansHypoglycemic AgentsRisk FactorsHypoglycemic Agents

Identifiers

PMID37220263
PMCPMC10234755
OpenAlexW4377693361

What Socratic holds

Textmetadata
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.