Abstract：
Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been shown to have benefit in patients with heart failure (HF). Multiple systematic reviews and meta-analyses (SRs and MAs) of randomized control trials (RCTs) comparing SGLT2i to placebo have been performed. However, there is uncertainty in the quality of the evidence and associated efficacy. We performed an overview of SRs and MAs of RCTs to summarize the evidence related to the efficacy of SGLT2i for the management of HF.
A comprehensive search of three databases (the Cochrane Library, EMBASE, and PubMed) was conducted until February 21, 2021. All SRs of RCTs evaluating the efficacy of SGLT2i in patients with HF were eligible for inclusion. The primary outcome was all-cause mortality. Methodological quality was evaluated using the AMSTAR-2 assessment tool. The overall quality of evidence was summarized using the Grading of Recommendations Assessment, Development, and Evaluation method. The initial search yielded 3431 references, of which, eight SRs and MAs met the inclusion criteria. The methodological quality ranged from critically low to high. The overall quality of evidence ranged from very low to moderate. Most of the SRs and MAs showed benefits in all-cause mortality, HF-related hospitalizations, and KCCQ score change.
SGLT2i are possibly beneficial in patients with HF, however, none of the SRs and MAs compared the efficacy between different types of SGLT2i. Furthermore, this paper emphasizes the need for consistent reproducible conduct and reporting of SRs to generate high-quality evidence and facilitate clinical decision-making.
A comprehensive search of three databases (the Cochrane Library, EMBASE, and PubMed) was conducted until February 21, 2021. All SRs of RCTs evaluating the efficacy of SGLT2i in patients with HF were eligible for inclusion. The primary outcome was all-cause mortality. Methodological quality was evaluated using the AMSTAR-2 assessment tool. The overall quality of evidence was summarized using the Grading of Recommendations Assessment, Development, and Evaluation method. The initial search yielded 3431 references, of which, eight SRs and MAs met the inclusion criteria. The methodological quality ranged from critically low to high. The overall quality of evidence ranged from very low to moderate. Most of the SRs and MAs showed benefits in all-cause mortality, HF-related hospitalizations, and KCCQ score change.
SGLT2i are possibly beneficial in patients with HF, however, none of the SRs and MAs compared the efficacy between different types of SGLT2i. Furthermore, this paper emphasizes the need for consistent reproducible conduct and reporting of SRs to generate high-quality evidence and facilitate clinical decision-making.
摘要：
目的：钠-葡萄糖协同转运蛋白-2抑制剂（SGLT2i）已被证明对心力衰竭（HF）患者有益处。已对SGLT2i与安慰剂进行了比较的随机对照试验（RCT）的多个系统评价和荟萃分析（SRs和MAs）。然而,证据质量和相关疗效存在不确定性.我们对RCT的SRs和MA进行了概述，以总结与SGLT2i治疗HF疗效相关的证据。
结果：对三个数据库的全面搜索（CochraneLibrary，EMBASE,和PubMed)进行到2021年2月21日。评价SGLT2i在HF患者中的疗效的RCT的所有SR均符合纳入条件。主要结果是全因死亡率。使用AMSTAR-2评估工具评估方法学质量。使用建议分级评估来总结证据的总体质量，发展,和评价方法。最初的搜索产生了3431个参考文献，其中，八名SR和MA符合纳入标准。方法学质量从极低到极高不等。证据的总体质量从非常低到中等。大多数SR和MA在全因死亡率方面显示出益处，HF相关的住院治疗,和KCCQ分数变化。
结论：SGLT2i可能对HF患者有益，然而,没有一个SR和MA比较不同类型SGLT2i的疗效。此外，本文强调需要一致的可重复行为和SRs报告,以产生高质量的证据并促进临床决策.
结果：对三个数据库的全面搜索（CochraneLibrary，EMBASE,和PubMed)进行到2021年2月21日。评价SGLT2i在HF患者中的疗效的RCT的所有SR均符合纳入条件。主要结果是全因死亡率。使用AMSTAR-2评估工具评估方法学质量。使用建议分级评估来总结证据的总体质量，发展,和评价方法。最初的搜索产生了3431个参考文献，其中，八名SR和MA符合纳入标准。方法学质量从极低到极高不等。证据的总体质量从非常低到中等。大多数SR和MA在全因死亡率方面显示出益处，HF相关的住院治疗,和KCCQ分数变化。
结论：SGLT2i可能对HF患者有益，然而,没有一个SR和MA比较不同类型SGLT2i的疗效。此外，本文强调需要一致的可重复行为和SRs报告,以产生高质量的证据并促进临床决策.
