Merész Gergő, Szabó Szilvia, Dóczy Veronika, Hölgyesi Áron, Szakács Zsolt
Technológiaértékelő Főosztály,Országos Gyógyszerészeti és Élelmezés-egészségügyi IntézetBudapest, Zrínyi u. 3., 1051.
Általános Orvostudományi Kar, Transzlációs Medicina Intézet,Pécsi TudományegyetemPécs.
Orv Hetil. 2020 Mar;161(13):491-501. doi: 10.1556/650.2020.31690.
The of this research was to conduct a network meta-analysis based on a systematic literature search to compare the relative frequency of urinary tract infections using sodium-glucose cotransporter-2 (SGLT2) inhibitors combined with metformin in the therapy of type 2 diabetes. MEDLINE and EMBASE databases were searched to identify publications of randomized, controlled trials investigating SGLT2 inhibitors combined with metformin in the therapy of type 2 diabetes and providing information on the frequency of urinary tract infections. 10 165 unique citations were screened to identify 10 publications to be included in the network meta-analysis. The network meta-analysis showed reduced risk of urinary tract infections for low-dose ertugliflozin compared to other SGLT2 inhibitors (ertugliflozin 5 mg vs. empagliflozin 10 mg: RR: 0.606, 95% CrI: 0.264-1.415; ertugliflozin 5 mg vs. dapagliflozin 10 mg: RR = 0.853, 95% CrI: 0.301-2.285). For high-dose comparisons, empagliflozin 25 mg showed reduced risk of urinary tract infections compared to both ertugliflozin 15 mg (RR = 0.745, 95% CrI 0.330-1.610) and dapagliflozin 10 mg (RR = 0.680, 95% CrI: 0.337-1.289). The difference between active substances and their doses was not statistically significant for the relative frequency of urinary tract infections. The meta-regression revealed a statistically significant association between baseline fasting plasma glucose level and relative frequency of urinary tract infections (β = 0.785, 95% CrI: 0.062-1.587). There was no statistically significant difference between SGLT2 inhibitors investigated in this study in terms of the relative frequency of urinary tract infections. This research demonstrates the applicability of network meta-analyses when assessing the relative effectiveness and safety of interventions. Orv Hetil. 2020; 161(13): 491-501.
本研究旨在基于系统的文献检索进行网络荟萃分析，以比较使用钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂联合二甲双胍治疗2型糖尿病时尿路感染的相对发生率。检索MEDLINE和EMBASE数据库，以识别关于SGLT2抑制剂联合二甲双胍治疗2型糖尿病并提供尿路感染发生率信息的随机对照试验出版物。筛选了10165条独特的引文，以确定10篇纳入网络荟萃分析的出版物。网络荟萃分析显示，与其他SGLT2抑制剂相比，低剂量依鲁格列净降低了尿路感染风险（依鲁格列净5mg对比恩格列净10mg：RR：0.606，95%可信区间：0.264-1.415；依鲁格列净5mg对比达格列净10mg：RR = 0.853，95%可信区间：0.301-2.285）。对于高剂量比较，恩格列净25mg与依鲁格列净15mg（RR = 0.745，95%可信区间0.330-1.610）和达格列净10mg（RR = 0.680，95%可信区间：0.337-1.289）相比，尿路感染风险均降低。活性物质及其剂量之间在尿路感染相对发生率方面差异无统计学意义。荟萃回归显示，基线空腹血糖水平与尿路感染相对发生率之间存在统计学显著关联（β = 0.785，95%可信区间：0.062-1.587）。本研究中调查的SGLT2抑制剂在尿路感染相对发生率方面无统计学显著差异。本研究证明了网络荟萃分析在评估干预措施的相对有效性和安全性时的适用性。《匈牙利医学周报》。2020年；161(13): 491-501。
