The Right Diabetes Medication for the Right Patient for the Right Outcome: Can a Network Meta-analysis Help Us Decide?
Authors: Christine G. Lee, William T. Cefalu
Journal: Annals of Internal Medicine (2020)

Editorials18 August 2020The Right Diabetes Medication for the Right Patient for the Right Outcome: Can a Network Meta-analysis Help Us Decide?Christine G. Lee, MD, MS and William T. Cefalu, MDChristine G. Lee, MD, MSNational Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland (C.G.L., W.T.C.) and William T. Cefalu, MDNational Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland (C.G.L., W.T.C.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M20-4266 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The landscape of diabetes care has grown increasingly complex for patients with type 2 diabetes. Guidelines recognize the need to account for heterogeneous characteristics of patients (such as diabetes duration, cardiovascular risk, risks for adverse drug effects, and comorbidities) so that patients can be put at the center of care and treatment targets and goals can be individualized (1, 2). Since the U.S. Food and Drug Administration issued guidance in December 2008 requiring trial designs and outcomes for new type 2 diabetes therapies to demonstrate cardiovascular safety, evidence has expanded for new drug classes (sodium–glucose cotransporter-2 [SGLT-2] inhibitors and glucagon-like ...References1. American Diabetes Association. 6. Glycemic targets: Standards of Medical Care in Diabetes—2020. Diabetes Care. 2020;43:S66-S76. [PMID: 31862749] doi:10.2337/dc20-S006 CrossrefMedlineGoogle Scholar2. American Diabetes Association. 9. Pharmacologic approaches to glycemic treatment: Standards of Medical Care in Diabetes—2020. Diabetes Care. 2020;43:S98-S110. [PMID: 31862752] doi:10.2337/dc20-S009 CrossrefMedlineGoogle Scholar3. Riley RD, Jackson D, Salanti G, et al. Multivariate and network meta-analysis of multiple outcomes and multiple treatments: rationale, concepts, and examples. BMJ. 2017;358:j3932. [PMID: 28903924] doi:10.1136/bmj.j3932 CrossrefMedlineGoogle Scholar4. Tsapas A, Avgerinos I, Karagiannis T, et al. Comparative effectiveness of glucose-lowering drugs for type 2 diabetes. A systematic review and network meta-analysis. Ann Intern Med. 2020;173:278-86. doi:10.7326/M20-0864 LinkGoogle Scholar5. Palmer SC, Mavridis D, Nicolucci A, et al. Comparison of clinical outcomes and adverse events associated with glucose-lowering drugs in patients with type 2 diabetes: a meta-analysis. JAMA. 2016;316:313-24. [PMID: 27434443] doi:10.1001/jama.2016.9400 CrossrefMedlineGoogle Scholar6. Zheng SL, Roddick AJ, Aghar-Jaffar R, et al. Association between use of sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide 1 agonists, and dipeptidyl peptidase 4 inhibitors with all-cause mortality in patients with type 2 diabetes: a systematic review and meta-analysis. JAMA. 2018;319:1580-1591. [PMID: 29677303] doi:10.1001/jama.2018.3024 CrossrefMedlineGoogle Scholar7. Hutton B, Salanti G, Caldwell DM, et al. The PRISMA Extension Statement for Reporting of Systematic Reviews Incorporating Network Meta-analyses of Health Care Interventions: checklist and explanations. Ann Intern Med. 2015;162:777-84. [PMID: 26030634]. doi:10.7326/M14-2385 LinkGoogle Scholar8. Karagiannis T, Avgerinos I, Toumpalidou M, et al. Patients' and clinicians' preferences on outcomes and medication attributes for type 2 diabetes: a mixed-methods study. J Gen Intern Med. 2020. [PMID: 31898143] doi:10.1007/s11606-019-05608-0 CrossrefMedlineGoogle Scholar9. Kent DM, van Klaveren D, Paulus JK, et al. The Predictive Approaches to Treatment effect Heterogeneity (PATH) statement: explanation and elaboration. Ann Intern Med. 2020;172:W1-W25. [PMID: 31711094]. doi:10.7326/M18-3668 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland (C.G.L., W.T.C.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-4266.Corresponding Author: Christine G. Lee, MD, MS, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 6707 Democracy Boulevard, Room 7217, Bethesda, MD 20892-5460; e-mail, Christine.[email protected]gov.Current Author Addresses: Drs. Lee and Cefalu: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 6707 Democracy Boulevard, Bethesda, MD 20892-5460.This article was published at Annals.org on 30 June 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComparative Effectiveness of Glucose-Lowering Drugs for Type 2 Diabetes Apostolos Tsapas , Ioannis Avgerinos , Thomas Karagiannis , Konstantinos Malandris , Apostolos Manolopoulos , Panagiotis Andreadis , Aris Liakos , David R. Matthews , and Eleni Bekiari Metrics Cited byProbiotics-based interventions for diabetes mellitus: A reviewThe Impact of Glucose-Lowering Drugs on Sarcopenia in Type 2 Diabetes: Current Evidence and Underlying Mechanisms 18 August 2020Volume 173, Issue 4Page: 311-312KeywordsCardiovascular disease riskCardiovascular diseasesDrugsHospitalizationsMortalityNetwork analysisRenal diseasesTreatment guidelinesType 2 diabetes ePublished: 30 June 2020 Issue Published: 18 August 2020 PDF downloadLoading ...