Department of Pharmacology, All India Institute of Medical Sciences, Rishikesh, India.
Sultan Qaboos Univ Med J. 2024 Aug;24(3):317-326. doi: 10.18295/squmj.12.2023.093. Epub 2024 Aug 29.
This meta-analysis investigated efficacy of dapagliflozin as adjunctive therapy for patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) stages 2-5. A systematic search was conducted of selected databases for randomised controlled trials that reported the mean change in estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (UACR) from baseline. Out of 1,682 identified studies, 9 trials comprising 13,057 patients were included. A pooled estimate of 5 studies indicated that dapagliflozin did not affect eGFR; however, in 2 studies, it significantly reduced chronic eGFR decline compared to placebo (mean difference [MD] ± 2.74; 95% confidence interval [CI]: 1.55, 3.92; <0.00001). Additionally, a pooled estimate of 4 studies showed that dapagliflozin significantly reduced UACR (MD -23.99%; 95% CI: -34.82--13.15; <0.0001; I = 0%). Therefore, long-term use of dapagliflozin significantly attenuates eGFR decline and reduces albuminuria in patients with T2DM and CKD.
本荟萃分析研究了达格列净作为 2 型糖尿病（T2DM）和慢性肾脏病（CKD）2-5 期患者辅助治疗的疗效。对选定数据库进行了系统检索，以寻找报告基线时估算肾小球滤过率（eGFR）和尿白蛋白/肌酐比值（UACR）平均变化的随机对照试验。在确定的 1682 项研究中，有 9 项试验共纳入了 13057 名患者。5 项研究的汇总估计表明，达格列净对 eGFR 没有影响；然而，在 2 项研究中，与安慰剂相比，它显著降低了慢性 eGFR 下降（平均差异 [MD] ± 2.74；95%置信区间 [CI]：1.55，3.92；<0.00001）。此外，4 项研究的汇总估计表明，达格列净显著降低了 UACR（MD-23.99%；95%CI：-34.82--13.15；<0.0001；I = 0%）。因此，长期使用达格列净可显著减缓 T2DM 和 CKD 患者的 eGFR 下降并减少白蛋白尿。
