Effect of glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors on time to outcome in type 2 diabetes cardiorenal outcome trials.

In randomized controlled trials (RCTs), treatment effects are commonly reported as hazard ratio, a measure often misinterpreted as a relative risk reduction. The acceleration factor (AF) indicates the extent to which a treatment increases/decreases the time before the occurrence of an outcome and gives useful insights in the interpretation of trials' results. Using individual time-to-event data reconstructed from Kaplan-Meier plots, we estimated AFs for the primary outcomes (POs) and all-cause mortality in glucagon-like peptide-1 receptor agonists (GLP1-RAs) or sodium-glucose cotransporter-2 inhibitors (SGLT2-is) cardiorenal outcome trials in subjects with type 2 diabetes. AFs were estimated from 28 Kaplan-Meier plots of 19 RCTs. Compared to placebo, most GLP1-RAs increased the time before the onset of POs (from 9 % to 59 %) and all-cause mortality (from 8 to 13 %). Similarly, SGLT2-is increased time before the onset of POs (from 19 % to 87 %) and all-cause mortality (from 13 % to 42 %). The AFs provide a complementary and easier-to-interpret measure of treatment effect that could be useful to improve the shared decision-making.

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Copyright © 2024. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Alessandro Rizzi reports a relationship with Novo Nordisk Inc that includes: consulting or advisory, speaking and lecture fees, and travel reimbursement. Alessandro Rizzi reports a relationship with Medtronic Inc that includes: speaking and lecture fees. Alessandro Rizzi reports a relationship with Boehringer Ingelheim GmbH that includes: speaking and lecture fees. Alessandro Rizzi reports a relationship with LifeScan Inc that includes: consulting or advisory and speaking and lecture fees. Dario Pitocco, Kamlesh Khunti, Melanie J Davies reports a relationship with Novo Nordisk Inc that includes: consulting or advisory and speaking and lecture fees. Dario Pitocco, Melanie J Davies reports a relationship with Medtronic Inc that includes: consulting or advisory and speaking and lecture fees. Dario Pitocco, Kamlesh Khunti, Melanie J Davies reports a relationship with Boehringer Ingelheim GmbH that includes: consulting or advisory and speaking and lecture fees. Dario Pitocco, Kamlesh Khunti, Melanie J Davies reports a relationship with AstraZeneca Pharmaceuticals LP that includes: consulting or advisory and speaking and lecture fees. Dario Pitocco, Kamlesh Khunti, Melanie J Davies reports a relationship with Eli Lilly and Company that includes: consulting or advisory and speaking and lecture fees. Dario Pitocco, Kamlesh Khunti, Melanie J Davies reports a relationship with Sanofi that includes: consulting or advisory and speaking and lecture fees. Kamlesh Khunti reports a relationship with Merck & Co Inc that includes: consulting or advisory and speaking and lecture fees. Kamlesh Khunti reports a relationship with Bayer Corporation that includes: consulting or advisory and speaking and lecture fees. Kamlesh Khunti reports a relationship with Abbott that includes: consulting or advisory and speaking and lecture fees. Kamlesh Khunti reports a relationship with Roche that includes: consulting or advisory and speaking and lecture fees.