Meta-Analysed Numbers Needed to Treat of Novel Antidiabetic Drugs for Cardiovascular Outcomes
Authors' conclusion
We found only modest treatment benefits of GLP-1 receptor agonists and SGLT2 inhibitors for CM and HHF in primary type 2 diabetes mellitus populations. In primary heart failure populations, SGLT2 inhibitor benefits were substantial and comparable in efficacy to established heart failure medication.
Study context
- Population
- CV outcome trials in primary diabetes (14) and primary HF (2) populations16 cardiovascular outcome trials (CVOTs)
- Comparison
- DPP-4 inhibitors, GLP-1 receptor agonists and SGLT2 inhibitors vs placebo
- Outcome
- Meta-NNT for CV mortality and hospitalisation for HF
Methodological detailsrandom-effects meta-analysis, reconstructed individual patient time-to-event data, Kaplan-Meier data digitalised with WebPlotDigitizer 4.2 and Guyot et al. R code; Weibull regression models used to estimate NNT
- Random-effects meta-analysis
- Reconstructed individual patient time-to-event data
- Kaplan-Meier data digitalised with WebPlotDigitizer 4.2 and Guyot et al. R code; Weibull regression models used to estimate NNT
Pooled result
As reported in the abstract
Meta-NNT, CV mortality (13 studies, 96 860 patients) · median follow-up 30 months
DPP-4 inhibitors
178
Meta-NNT · 95% CI 64 to ∞ to −223
GLP-1 receptor agonists
261
Meta-NNT · 95% CI 158–745
SGLT2 inhibitors
118
Meta-NNT · 95% CI 68–435
Further pooled results
Meta-NNT
| Outcome | DPP-4 inhibitors | GLP-1 receptor agonists | SGLT2 inhibitors | Placebo | |
|---|---|---|---|---|---|
| Meta-NNT, hospitalisation for HF (10 studies, 96 128 patients) · median follow-up 29 monthsvs placebo | −644 (95% CI 229 to ∞ to −134) | 441 (95% CI 184 to ∞ to −1100) | 126 (95% CI 91–208) | Not reported in the abstract | Placebo: not reported in the abstract |
Meta-NNT, hospitalisation for HF with SGLT2 inhibitors, by population (subgroup) · 16 months
- Primary HF populations
- 25 (19 to 39)
- Primary diabetes populations
- 233 (167 to 385)
Original publication
Meta-Analysed Numbers Needed to Treat of Novel Antidiabetic Drugs for Cardiovascular Outcomes. ESC Heart Fail. Published 7 November 2022. doi:10.
Summarised from the published abstract; every number is checked against it