Introduction and aim: The of this research was to conduct a network meta-analysis
based on a systematic literature search to compare the relative frequency of urinary
tract infections using sodium-glucose cotransporter-2 (SGLT2) inhibitors combined
with metformin in the therapy of type 2 diabetes. Method: MEDLINE and EMBASE databases
were searched to identify publications of randomized, controlled trials investigating
SGLT2 inhibitors combined with metformin in the therapy of type 2 diabetes and providing
information on the frequency of urinary tract infections. Results: 10 165 unique citations
were screened to identify 10 publications to be included in the network meta-analysis.
The network meta-analysis showed reduced risk of urinary tract infections for low-dose
ertugliflozin compared to other SGLT2 inhibitors (ertugliflozin 5 mg vs. empagliflozin
10 mg: RR: 0.606, 95% CrI: 0.264-1.415; ertugliflozin 5 mg vs. dapagliflozin 10 mg:
RR = 0.853, 95% CrI: 0.301-2.285). For high-dose comparisons, empagliflozin 25 mg
showed reduced risk of urinary tract infections compared to both ertugliflozin 15
mg (RR = 0.745, 95% CrI 0.330-1.610) and dapagliflozin 10 mg (RR = 0.680, 95% CrI:
0.337-1.289). The difference between active substances and their doses was not statistically
significant for the relative frequency of urinary tract infections. The meta-regression
revealed a statistically significant association between baseline fasting plasma glucose
level and relative frequency of urinary tract infections (β = 0.785, 95% CrI: 0.062-1.587).
Conclusion: There was no statistically significant difference between SGLT2 inhibitors
investigated in this study in terms of the relative frequency of urinary tract infections.
This research demonstrates the applicability of network meta-analyses when assessing
the relative effectiveness and safety of interventions. Orv Hetil. 2020; 161(13):
491-501.
