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
Davies, Melanie J Zaccardi, Francesco
Davies, Melanie J
Zaccardi, Francesco
Abstract
Introduction: 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.
Methods: 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.
Results: 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 %).
Conclusions: 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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Date
2024-01-12
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Rizzi, A., Kloecker, D. E., Pitocco, D., Khunti, K., Davies, M. J., & Zaccardi, F. (2024). 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. Diabetes & metabolic syndrome, 18(2), 102945. Advance online publication. https://doi.org/10.1016/j.dsx.2024.102945