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Eight different diabetes drug classes examined in a meta-analysis failed to demonstrate improved cardiovascular or all-cause mortality compared with placebo.
Researchers analyzed 301 randomized clinical trials of patients with type 2 diabetes, and found that, metformin outperformed some other drug classes for its effect on hemoglobin A1c levels, there were no significant differences in mortality -- including when placebo was included as a drug class.
Of all the classes, sodium-glucose cotransporter-2 (SGLT2) drugs were associated with the lowest odds of hypoglycemia when added to metformin (odds ratio 0.12, 95% CI 0.008-0.18; risk difference -22%), but when when added to both metformin and sulfonylurea, glucagon-like peptide-1 receptor agonists had the lowest odds (OR 0.60, 95% CI 0.39-0.94; risk difference 10%), according to lead author Suetonia Palmer, PhD, at the University of Otago Christchurch in New Zealand.
Palmer and colleagues published their findings on Tuesday in the Journal of the American Medical Association.
"A central finding in this meta-analysis was that despite more than 300 available clinical trials involving nearly 120,000 adults and 1.4 million patient-months of treatment, there was limited evidence that any glucose-lowering drug stratified by coexisting treatment prolonged life expectancy or prevented cardiovascular disease," the authors wrote.
Four classes of drugs were associated with higher HbA1c levels when compared to metformin.
More on this new paper here http://www.medpagetoday.com/endocrinology/diabetes/59182
Researchers analyzed 301 randomized clinical trials of patients with type 2 diabetes, and found that, metformin outperformed some other drug classes for its effect on hemoglobin A1c levels, there were no significant differences in mortality -- including when placebo was included as a drug class.
Of all the classes, sodium-glucose cotransporter-2 (SGLT2) drugs were associated with the lowest odds of hypoglycemia when added to metformin (odds ratio 0.12, 95% CI 0.008-0.18; risk difference -22%), but when when added to both metformin and sulfonylurea, glucagon-like peptide-1 receptor agonists had the lowest odds (OR 0.60, 95% CI 0.39-0.94; risk difference 10%), according to lead author Suetonia Palmer, PhD, at the University of Otago Christchurch in New Zealand.
Palmer and colleagues published their findings on Tuesday in the Journal of the American Medical Association.
"A central finding in this meta-analysis was that despite more than 300 available clinical trials involving nearly 120,000 adults and 1.4 million patient-months of treatment, there was limited evidence that any glucose-lowering drug stratified by coexisting treatment prolonged life expectancy or prevented cardiovascular disease," the authors wrote.
Four classes of drugs were associated with higher HbA1c levels when compared to metformin.
More on this new paper here http://www.medpagetoday.com/endocrinology/diabetes/59182
