| DOI: DOI:10.29090/psa.2024.03.24.AP0606 | Pharm Sci Asia 2024; 51(4), 326-335 |
Effects of SGLT2 Inhibitors Compared with Sulfonylurea on Glycaemic Control and Cardiovascular Risk Reduction in Asia: Meta-AnalysisFonny Cokro1, Rani Sauriasari1*, Dicky Levenus Tahapary2,3, Heri Setiawan4,5
1 Clinical and Social Pharmacy Laboratory, Faculty of Pharmacy, Universitas Indonesia, Depok 16424, West Java, Indonesia
2
Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
3
Metabolic, Cardiovascular, and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
4
Department of Pharmacology, Faculty of Pharmacy, Universitas Indonesia, Depok 16424, West Java, Indonesia
5
National Metabolomics Collaborative Research Center, Faculty of Pharmacy, Universitas Indonesia, Depok 16424, West Java, Indonesia
International guidelines recommend using Sodium-Glucose Transporter 2 Inhibitors (SGLT2is) for Type 2 Diabetes Mellitus (T2DM) patients. However, there are possible disparities in glycaemic control outcomes among various races and ethnicities. Meanwhile, sulfonylurea is often administered as oral antidiabetic medications in Asia. This study examines the glycaemic control and cardiovascular risk components of SGLT2 inhibitors and sulfonylurea in Asian adults with T2DM. Protocol CRD420234480943 is registered with Prospero. Until February 15, 2024, PubMed, CENTRAL, and EMBASE were searched for pertinent papers. The primary outcome of this Asian T2DM study is the reduction of HbA1c. Secondary outcomes include fasting plasma glucose level, blood pressure, cholesterol profile, and anthropometric measurements. The RoB2 tool assessed bias risk, and Review Manager 5.3 synthesized data. The GRADE framework assessed certainty. Seven articles containing 890 participants were chosen for inclusion. The data analysis showed no statistically significant difference in the primary outcome of HbA1c between SGLT2is and sulfonylurea (MD = 0.06%; 95%CI = -0.13%-0.24%), with low certainty. The subgroup analysis of HbA1c showed a preference for dapagliflozin (MD = -0.36%; 95%CI = -0.63 to -0.08%). Secondary outcomes analysis indicates that SGLT2is have a more favorable effect on improving blood pressure, all anthropometric measurements, and High-Density Lipoprotein (HDL) level. In conclusion, glycaemic control shows no difference between SGLT2is and sulfonylurea. However, SGLT2is can enhance cardiovascular risk reduction. To address the low level of certainty in the data, more research is needed on SGLT2is dosage, type, and duration, especially in Asia.
Keyword:
Asia; Cardiovascular Risk; Glycaemic Control; Meta-Analysis; SGLT2 Inhibitors; Sulfonylurea
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