Meta-analysis of SGLT2 inhibitors and stroke risk in type 2 diabetic patients

Abstract

Objective To evaluate the effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors on the stroke risk for patients with type 2 diabetes mellitus (T2DM). Methods A systemic meta-analysis including 30 random control trails (RCTs) was performed to compare the risk of stroke between type 2 diabetic patients treated with SGLT2 inhibitors and control drugs. Then their bias risk and quality were assessed and meta-analysis was conducted using Stata12.0 software. Results Thirty RCTs enrolling 74 456 participants were selected for meta-analysis. The stroke incidence in the group receiving SGLT2 inhibitor monotherapy or combination therapy did not significantly differ from that in control group, with relative risk (RR) 1.01 (95%CI 0.93-1.10, P=0.978) and 1.00 (95%CI 0.92-1.09, P=0.874), respectively. Three SGLT2 inhibitors canagliflozin, dapagliflozin, and empagliflozin did not increase the risk of stroke, with similar RR values (RR=0.91, 0.99, 1.13, respectively). Subgroup analyses showed that there was no correlation between SGLT2 inhibitors and stroke risk in different gender, age, diabetes duration, body mass index, or HbA1C levels. Conclusions Whether administered as monotherapy or add-on therapy, SGLT2 inhibitors did not increase stroke incidence, and there were no significant within-class differences. (Chin J Endocrinol Metab, 2018, 34: 827-833) Key words: Sodium-glucose cotransporter 2 inhibitors; Diabetes mellitus, type 2; Stroke; Meta-analysis