A Methodological Framework for Meta-analysis and Clinical Interpretation of Subgroup Data: The Case of Major Adverse Cardiovascular Events With GLP-1 Receptor Agonists and SGLT2 Inhibitors in Type 2 Diabetes
Authors' conclusion
This framework can be applied to subgroup meta-analyses regardless of outcomes or modification variables.
Study context
- Population
- T2D CVOT subgroups: patients with established CVD and those at high CV risk without manifest CVD
- Comparison
- GLP-1 RA or SGLT2i vs placebo, by established CVD vs high CV risk without manifest CVD
- Outcome
- MACE
Methodological detailscredibility assessment of effect modification, translation of relative into absolute treatment effects
- Credibility assessment of effect modification
- Translation of relative into absolute treatment effects
Pooled result
As reported in the abstract
MACE (overall relative effect used for both subpopulations)
Each group vs placeboHazard ratio (95% CI)
GLP-1 RA
0.85(0.80–0.90)
SGLT2i
0.91(0.85–0.97)
Further pooled results
5-year absolute treatment effect on major adverse cardiovascular events (MACE) (fewer patients with event per 1,000 patients)
- GLP-1 RA, established CVD
- 30 fewer
- GLP-1 RA, without manifest CVD
- 14 fewer
- SGLT2i, established CVD
- 18 fewer
- SGLT2i, without manifest CVD
- 8 fewer
Original publication
A Methodological Framework for Meta-analysis and Clinical Interpretation of Subgroup Data: The Case of Major Adverse Cardiovascular Events With GLP-1 Receptor Agonists and SGLT2 Inhibitors in Type 2 Diabetes. Diabetes Care. Published 19 January 2024. doi:10.
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