Comparative efficacy and safety of SGLT2 inhibitor class members in patients with heart failure and type 2 diabetes: A systematic review and network meta-analysis of randomized controlled trials
Authors' conclusion
In patients with HF and T2DM, SGLT2i class effects include ACM, ACH, and HHF reduction. Among SGLT2i, canagliflozin showed greatest ACM, CVD, and HHF benefit.
Study context
- Population
- Patients with both heart failure (HF) and T2D; 5 databases searched up to April 15, 2025
- Participants
- 17,809 patients17 RCTs
- Comparison
- SGLT2i vs control; individual SGLT2i compared via network meta-analyses (NMA)
- Outcome
- All-cause mortality, cardiovascular death, all-cause hospitalization and hospitalization for HF
Methodological detailspairwise meta-analysis, p-score ranking
- Pairwise meta-analysis
- P-score ranking
Pooled result
As reported in the abstract
All-cause mortality, all-cause hospitalization, HF hospitalization, cardiovascular death
SGLT2i vs ControlEstimate (95% CI)
Low quality of evidence
HR (all-cause mortality) 0.87(0.78–0.98)
High quality of evidence
HR (all-cause hospitalization) 0.74(0.62–0.88)
Low quality of evidence
HR (HF hospitalization) 0.70(0.63–0.77)
Very low quality of evidence
HR (cardiovascular death) 0.87(0.76–1.00)
Further pooled results
Ranking of individual SGLT2i (NMA, p-scores)
- Canagliflozin ranked highest for decreasing all-cause mortality (p-score)
- 0.86
- Canagliflozin ranked highest for decreasing cardiovascular death (p-score)
- 0.82
- Canagliflozin ranked highest for decreasing HF hospitalization (p-score)
- 0.88
Original publication
Comparative efficacy and safety of SGLT2 inhibitor class members in patients with heart failure and type 2 diabetes: A systematic review and network meta-analysis of randomized controlled trials. Diabetes Res Clin Pract. Published 3 May 2025. doi:10.
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