Evidence mapPaperPMID 41414742Full record

Trial reportJournal of diabetes2025

Blood Pressure Status Modulates the Therapeutic Response to Sodium-Glucose Cotransporter 2 Inhibitors in Diabetic Macular Edema: A Post Hoc Subgroup Analysis of the COMET Trial.

Ryoichi Ishibashi, Masaya Koshizaka, Yoko Takatsuna, Tomoaki Tatsumi, Takayuki Baba, Shuichi Yamamoto, Koutaro Yokote

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of diabetes, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
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

1 citing paper in PubMed.

  1. Trial
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

7 authors.

Ryoichi IshibashiDepartment of Medicine, Division of Diabetes, Endocrinology and Metabolism, Kimitsu Chuo Hospital, Chiba, Japan.
Masaya KoshizakaDepartment of Endocrinology, Haematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan.ORCID https://orcid.org/0000-0001-7374-9993
Yoko TakatsunaDepartment of Ophthalmology, Chiba Rosai Hospital, Chiba, Japan.ORCID https://orcid.org/0000-0002-1209-0934
Tomoaki TatsumiDepartment of Ophthalmology and Vision Science, Chiba University Graduate School of Medicine, Chiba, Japan.ORCID https://orcid.org/0000-0001-8271-9403
Takayuki BabaDepartment of Ophthalmology and Vision Science, Chiba University Graduate School of Medicine, Chiba, Japan.
Shuichi YamamotoDepartment of Ophthalmology and Vision Science, Chiba University Graduate School of Medicine, Chiba, Japan.
Koutaro YokoteDepartment of Endocrinology, Haematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan.

Funding

Taisho Toyama Pharmaceutical Company
6 · The paper itself

Abstract

aimsTo evaluate the feasibility of sodium-glucose cotransporter 2 inhibitors (SGLT2i) as a systemic adjunct for patients with diabetic macular edema (DME) and hypertension. MATERIALS AND

methodsThis study encompassed a post hoc analysis of the COMET Trial data, focusing on patients with DME and hypertension, defined by office systolic blood pressure (OSBP) ≥ 140 mmHg or a documented history of hypertension. Participants were randomized to receive either SGLT2i (luseogliflozin) or sulfonylurea (SU, glimepiride). The primary outcome was the treatment burden, quantified by the total number of intravitreal ranibizumab injections (IVRs) over 48 weeks.

resultsWithin the OSBP ≥ 140 mmHg subgroup, 14 patients received SGLT2i and 15 received SU. The total number of IVRs was 4.1 ± 3.1 in the SGLT2i group and 6.8 ± 3.1 in the SU group (Cohen's d = 0.87; power = 0.82). The adjusted analysis of covariance further confirmed significantly fewer IVRs in the SGLT2i group (3.3 ± 1.1 vs. 6.2 ± 1.0, p = 0.025). OSBP was significantly reduced in the SGLT2i group at Week 12, but there was no significant difference at Week 48. Office diastolic blood pressure remained consistently lower in the SGLT2i group. No significant differences in IVR frequency were observed in other subgroups.

conclusionsSGLT2i may help reduce the treatment burden of IVRs in patients with DME and elevated OSBP. The improvements in blood pressure and visual acuity, despite fewer injections, indicate a potential synergistic effect of SGLT2i in managing DME with hypertension. Further investigation is warranted to validate its efficacy as a potential systemic adjunct.

trial registrationUMIN000057674.

Indexed as

Blood PressureDiabetes Mellitus, Type 2Diabetic RetinopathyHypertensionMacular EdemaSodium-Glucose Transporter 2 InhibitorsAgedFemaleHumansMaleMiddle AgedRanibizumabSorbitolSulfonylurea CompoundsTreatment Outcome1,5-anhydro-1-(5-(4-ethoxybenzyl)-2-methoxy-4-methylphenyl)-1-thioglucitolglimepirideRanibizumabSodium-Glucose Transporter 2 InhibitorsSorbitolSulfonylurea Compoundsanti‐vascular endothelial growth factor injectiondiabetic macular edemahypertensionsodium‐glucose cotransporter 2 inhibitor

Identifiers

PMID41414742
PMCPMC12715334

What Socratic holds

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Registered trials

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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.