Cardiovascular events and all-cause mortality associated with sulphonylureas compared with other antihyperglycaemic drugs: a Bayesian meta-analysis of survival data
Aim: To conduct a systematic review and meta-analysis to determine the risk of cardiovascular events and all-cause mortality associated with sulphonylureas (SUs) vs other glucose lowering drugs in patients with T2DM (T2DM. Materials and methods: A systematic review of Medline, Embase, Cochrane and...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
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Wiley InterScience
2017
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| Online Access: | https://eprints.nottingham.ac.uk/43902/ |
| _version_ | 1848796792456478720 |
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| author | Bain, Steve Druyts, Eric Balijepalli, Chakrapani Baxter, Carl A. Currie, Craig J. Das, Romita Donnelly, Richard Khunti, Kamlesh Langerman, Haya Leigh, Paul Siliman, Gaye Thorlund, Kristian Toor, Kabirraaj Vora, Jiten Mills, Edward J. |
| author_facet | Bain, Steve Druyts, Eric Balijepalli, Chakrapani Baxter, Carl A. Currie, Craig J. Das, Romita Donnelly, Richard Khunti, Kamlesh Langerman, Haya Leigh, Paul Siliman, Gaye Thorlund, Kristian Toor, Kabirraaj Vora, Jiten Mills, Edward J. |
| author_sort | Bain, Steve |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Aim: To conduct a systematic review and meta-analysis to determine the risk of cardiovascular events and all-cause mortality associated with sulphonylureas (SUs) vs other glucose lowering drugs in patients with T2DM (T2DM.
Materials and methods: A systematic review of Medline, Embase, Cochrane and clinicaltrials.gov was conducted for studies comparing SUs with placebo or other antihyperglycaemic drugs in patients with T2DM. A cloglog model was used in the Bayesian framework to obtain comparative hazard ratios (HRs) for the different interventions. For the analysis of observational data, conventional fixed-effect pairwise meta-analyses were used.
Results: The systematic review identified 82 randomized controlled trials (RCTs) and 26 observational studies. Meta-analyses of RCT data showed an increased risk of all-cause mortality and cardiovascular-related mortality for SUs compared with all other treatments combined (HR 1.26, 95% confidence interval [CI] 1.10-1.44 and HR 1.46, 95% CI 1.21-1.77, respectively). The risk of myocardial infarction was significantly higher for SUs compared with dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium-glucose co-transporter-2 inhibitors (HR 2.54, 95% CI 1.14-6.57 and HR 41.80, 95% CI 1.64-360.4, respectively). The risk of stroke was significantly higher for SUs than for DPP-4 inhibitors, glucagon-like peptide-1 agonists, thiazolidinediones and insulin.
Conclusions: The present meta-analysis showed an association between SU therapy and a higher risk of major cardiovascular disease-related events compared with other glucose lowering drugs. Results of ongoing RCTs, which should be available in 2018, will provide definitive results on the risk of cardiovascular events and all-cause mortality associated with SUs vs other antihyperglycaemic drugs. |
| first_indexed | 2025-11-14T19:53:37Z |
| format | Article |
| id | nottingham-43902 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:53:37Z |
| publishDate | 2017 |
| publisher | Wiley InterScience |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-439022020-05-04T18:33:21Z https://eprints.nottingham.ac.uk/43902/ Cardiovascular events and all-cause mortality associated with sulphonylureas compared with other antihyperglycaemic drugs: a Bayesian meta-analysis of survival data Bain, Steve Druyts, Eric Balijepalli, Chakrapani Baxter, Carl A. Currie, Craig J. Das, Romita Donnelly, Richard Khunti, Kamlesh Langerman, Haya Leigh, Paul Siliman, Gaye Thorlund, Kristian Toor, Kabirraaj Vora, Jiten Mills, Edward J. Aim: To conduct a systematic review and meta-analysis to determine the risk of cardiovascular events and all-cause mortality associated with sulphonylureas (SUs) vs other glucose lowering drugs in patients with T2DM (T2DM. Materials and methods: A systematic review of Medline, Embase, Cochrane and clinicaltrials.gov was conducted for studies comparing SUs with placebo or other antihyperglycaemic drugs in patients with T2DM. A cloglog model was used in the Bayesian framework to obtain comparative hazard ratios (HRs) for the different interventions. For the analysis of observational data, conventional fixed-effect pairwise meta-analyses were used. Results: The systematic review identified 82 randomized controlled trials (RCTs) and 26 observational studies. Meta-analyses of RCT data showed an increased risk of all-cause mortality and cardiovascular-related mortality for SUs compared with all other treatments combined (HR 1.26, 95% confidence interval [CI] 1.10-1.44 and HR 1.46, 95% CI 1.21-1.77, respectively). The risk of myocardial infarction was significantly higher for SUs compared with dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium-glucose co-transporter-2 inhibitors (HR 2.54, 95% CI 1.14-6.57 and HR 41.80, 95% CI 1.64-360.4, respectively). The risk of stroke was significantly higher for SUs than for DPP-4 inhibitors, glucagon-like peptide-1 agonists, thiazolidinediones and insulin. Conclusions: The present meta-analysis showed an association between SU therapy and a higher risk of major cardiovascular disease-related events compared with other glucose lowering drugs. Results of ongoing RCTs, which should be available in 2018, will provide definitive results on the risk of cardiovascular events and all-cause mortality associated with SUs vs other antihyperglycaemic drugs. Wiley InterScience 2017-02-27 Article PeerReviewed Bain, Steve, Druyts, Eric, Balijepalli, Chakrapani, Baxter, Carl A., Currie, Craig J., Das, Romita, Donnelly, Richard, Khunti, Kamlesh, Langerman, Haya, Leigh, Paul, Siliman, Gaye, Thorlund, Kristian, Toor, Kabirraaj, Vora, Jiten and Mills, Edward J. (2017) Cardiovascular events and all-cause mortality associated with sulphonylureas compared with other antihyperglycaemic drugs: a Bayesian meta-analysis of survival data. Diabetes, Obesity and Metabolism, 19 (3). pp. 329-335. ISSN 1462-8902 cardiovascular disease meta-analysis sulphonylureas systematic review T2DM http://onlinelibrary.wiley.com/doi/10.1111/dom.12821/abstract doi:10.1111/dom.12821 doi:10.1111/dom.12821 |
| spellingShingle | cardiovascular disease meta-analysis sulphonylureas systematic review T2DM Bain, Steve Druyts, Eric Balijepalli, Chakrapani Baxter, Carl A. Currie, Craig J. Das, Romita Donnelly, Richard Khunti, Kamlesh Langerman, Haya Leigh, Paul Siliman, Gaye Thorlund, Kristian Toor, Kabirraaj Vora, Jiten Mills, Edward J. Cardiovascular events and all-cause mortality associated with sulphonylureas compared with other antihyperglycaemic drugs: a Bayesian meta-analysis of survival data |
| title | Cardiovascular events and all-cause mortality associated with sulphonylureas compared with other antihyperglycaemic drugs: a Bayesian meta-analysis of survival data |
| title_full | Cardiovascular events and all-cause mortality associated with sulphonylureas compared with other antihyperglycaemic drugs: a Bayesian meta-analysis of survival data |
| title_fullStr | Cardiovascular events and all-cause mortality associated with sulphonylureas compared with other antihyperglycaemic drugs: a Bayesian meta-analysis of survival data |
| title_full_unstemmed | Cardiovascular events and all-cause mortality associated with sulphonylureas compared with other antihyperglycaemic drugs: a Bayesian meta-analysis of survival data |
| title_short | Cardiovascular events and all-cause mortality associated with sulphonylureas compared with other antihyperglycaemic drugs: a Bayesian meta-analysis of survival data |
| title_sort | cardiovascular events and all-cause mortality associated with sulphonylureas compared with other antihyperglycaemic drugs: a bayesian meta-analysis of survival data |
| topic | cardiovascular disease meta-analysis sulphonylureas systematic review T2DM |
| url | https://eprints.nottingham.ac.uk/43902/ https://eprints.nottingham.ac.uk/43902/ https://eprints.nottingham.ac.uk/43902/ |