Effectiveness of SGLT2 inhibitors, incretin-based therapies, and finerenone on cardiorenal outcomes: a meta-analysis and network meta-analysis

作者：Arveen Shokravi, Jayant Seth, Nelson Lu, G.B. John Mancini · 发表于：Cardiovascular Diabetology – Endocrinology Reports · 年份：2025 · DOI：10.1186/s40842-025-00248-2 · 被引用次数：12 · 研究领域：Diabetes Treatment and Management、Bariatric Surgery and Outcomes、Heart Failure Treatment and Management

BACKGROUND: Several societies recommend sodium-glucose co-transporter 2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1RA), and finerenone for cardiorenal risk reduction in select populations. This updated meta-analysis assessed the impact of SGLT2i, incretin-based therapies (i.e. GLP-1RAs and tirzepatide), and finerenone on cardiorenal outcomes in established and emerging populations. Additionally, a network meta-analysis (NMA) compared the relative efficacy between treatment classes. METHODS: A systematic search of MEDLINE and CENTRAL from January 2023 to April 2025, supplemented by studies evaluated in our prior meta-analyses, identified 33 randomized controlled trials. Random-effects models were used to generate hazard ratios for outcomes including cardiovascular (CV) mortality, all-cause mortality, heart failure (HF) hospitalization/event, non-fatal myocardial infarction (MI), non-fatal stroke, and kidney composite outcomes in various subpopulations including patients with type 2 diabetes (T2D) with atherosclerotic cardiovascular disease (ASCVD) or high CV risk, chronic kidney disease (CKD), HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), HFpEF with obesity, post-MI, acute HF, and ASCVD with overweight/obesity without T2D. NMA was performed when two or more treatment classes were reported for a given outcome within a subpopulation. RESULTS: Incretin-based therapies decreased CV mortality, all-cause mortality, ...