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. 2024 May 31:15:1403606.
doi: 10.3389/fendo.2024.1403606. eCollection 2024.

Long-term effects of different hypoglycemic drugs on carotid intima-media thickness progression: a systematic review and network meta-analysis

Qianyu Lv #  1 , Yingtian Yang #  1 , Yanfei Lv  2 , Qian Wu  1 , Xinzheng Hou  1 , Lanlan Li  1 , Xuejiao Ye  1 , Chenyan Yang  1 , Shihan Wang  1
Affiliations

Long-term effects of different hypoglycemic drugs on carotid intima-media thickness progression: a systematic review and network meta-analysis

Qianyu Lv et al. Front Endocrinol (Lausanne). .

Abstract

Objective: The progression of carotid intima-media thickness (cIMT) can partially predict the occurrence of future cardiovascular events. This network meta-analysis compared the effects of 14 antidiabetic drugs (acarbose, alogliptin, exenatide, glibenclamide, glimepiride, ipragliflozin, metformin, nateglinide, pioglitazone, rosiglitazone, sitagliptin, tofoglifozin, troglitazone, voglibose) on the progression of cIMT.

Method: PubMed, EMBASE, Cochrane Library, and Web of Science were searched to screen all clinical trials of treatment of cIMT with hypoglycemic agents before March 1, 2024. The differences in the changes in cIMT between the treatment group and control group were evaluated.

Result: After screening 8395 citations, 25 studies (6675 patients) were included. The results indicated that exenatide had the best efficacy in slowing down cIMT progress, and exenatide [MD=-0.13,95%CI (-0.25, -0.01)], alogliptin [MD=-0.08,95%CI (-0.13, -0.02)] and metformin [MD=-0.05, 95%CI (-0.09, -0.02)] are more effective than placebo.

Conclusion: Long-term treatment of exenatide, alogliptin, and metformin may be more effective than other hypoglycemic drugs in slowing the progression of cIMT.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024519474.

Keywords: antidiabetic drug; atherosclerosis; cardiovascular; diabetes; intima-media thickness.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of literature screening in the NMA.
Figure 2
Figure 2
Risk of bias traffic light plot of ROB 2 assessments.
Figure 3
Figure 3
Network plot of clinical trials on HDs or PLC patients. Nodes stand for the comparison between treatments and the size is proportional to the number of subjects. The width of the lines is proportional to the number of trials per pair of interventions.
Figure 4
Figure 4
Forest plot showing the outcomes of NMA (relative differences of various HDs in reducing cIMT compared with PLC).
Figure 5
Figure 5
Plot of funnel (A, acarbose; B, alogliptin; C, exenatide; D, glibenclamide; E, glimepiride; F, ipragliflozin; G, metformin; H, nateglinide; I, PLC; J, pioglitazone; K, rosiglitaxone; L, sitagliptin; M, tofoglifozin; N, roglitaxone; O, voglibose).
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