Efficacy and safety of sodium-glucose co-transporter 2 inhibitors in the elderly versus non-elderly patients with type 2 diabetes mellitus: a meta-analysis

Endocrine journal

article

Yao Wang¹  Xian Shao²  Zewen Liu³ 

[1] Department of Endocrinology and Metabolism, Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu University;NHC Key Laboratory of Hormones and Development ,(Tianjn Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjn Medical University Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology;Tianjin First Central Hospital

关键词: Sodium-glucose co-transporter 2 inhibitors (SGLT2i);    Old patients;    Type 2 diabetes;    Efficacy;    Safety;   

DOI  :  10.1507/endocrj.EJ21-0616

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

This meta-analysis was performed to compare the influence of sodium-glucose co-transporter 2 inhibitors (SGLT2i) on the efficacy and safety of elderly patients with type 2 diabetes with the young ones. PubMed, Medline, Web of Science, EMbase, and Cochrane Library were searched for literature published before March 2020 to identify studies comparing efficacy and safety of SGLT2i in elderly diabetes patients (≥65 years) and young controls (<65 years). A fixed or random-effect model was used to calculate the summary standard means difference and odds ratios. A total of 13 articles with data for 86,433 participants were included. Old patients receiving SGLT2i had a smaller reduction in hemoglobin A1c (SMD = –0.07, 95% CI –0.14 to –0.00, p = 0.044) than young ones. They had higher incidence of serious adverse events (SAEs) (OR 1.78, 95% CI 1.25–2.55, p = 0.001), AE leading to discontinuation (OR 2.34, 95%CI 1.53–3.59, p = 0.000), volume depletion (OR 2.80, 95% CI 1.82–4.32, p = 0.000) , and urinary tract infections (OR 1.37, 95% CI 1.18–1.60, p = 0.000), and renal function impairment (OR 2.61, 95% CI 1.78–3.81, p = 0.000) than young patients, and there was a opposite result in genital mycotic infections (OR 0.69, 95% CI 0.55–0.87, p = 0.002). No significant differences were recorded in the reduction of fasting blood glucose, blood pressure, body weight, and in incidence of overall AEs and fracture. In summary, relatively satisfying efficacy was observed in the elderly patients receiving SGLT2i. Although some AEs were more prevalent among older patients, the majority of them were generally mild.

【 授权许可】

Unknown