Table 2.
Overview of results of randomized controlled trials assessing the effect of the introduction of antidiabetics in patients with SARS-CoV-2 infection.
| Drug | Endpoint | Comparator | No. of participants | Result Point estimate (95% CI) or N (%) or median |
Reference |
|---|---|---|---|---|---|
| Metformin | Hospitalization | Placebo | 418 | RR 1.14 (0.73–1.81) | (12) |
| Viral clearance at day 7 | OR 0.99 (0.88–1.11) | ||||
| Fatalities on day 28 (drug vs. placebo) | 7 (3.3%) vs. 9 (4.4%), p = 0.53 | ||||
| Adverse drug reactions | RR 1.02 (0.73–1.45) | ||||
| Clinical improvement on day 28 | OR 1.05 (0.71–1.56) | ||||
| Metformin | Composite end point (hypoxemia, emergency department visit, hospitalization, or death) | Placebo | 1,431 | OR 0.84 (0.66–1.09) | (34) |
| Hospitalization or death | OR 0.47 (0.20–1.11) | ||||
| Dapagliflozin (SGLT-2 inhibitor) | Time to new or worsened organ dysfunction or death | Placebo | 1,250 | HR 0·80 (0.58–1.10) | (11) |
| Change in clinical status by day 30 (recovery) | Win ratio 1.09 (0.97–1.22) | ||||
| Adverse events (drug vs. placebo) | 65 (10.6%) vs. 82 (13.3%), p not reported | ||||
| Empagliflozin (SGLT-2 inhibitor) | 28-day mortality | Usual care | 4,271 | Rate ratio 0.96 (0.82–1.13) | (35)* |
| Duration of hospitalization (drug vs. placebo) | Median 8 days vs. median 8 days | ||||
| Composite of invasive mechanical ventilation or death | RR 0.95 (0.84–1.08) | ||||
| Dapagliflozin (SGLT-2 inhibitor) | Organ support-free days evaluated through 21 days | Usual care | 575 | OR 0.74 (0.48–1.13) | (36)* |
| Pioglitazone | The incidence of a composite outcome composed of (a) the requirement for mechanical ventilation, (b) death, and (c) myocardial damage (drug vs. placebo) | Placebo | 350 | 14 (7.4%) vs. 14 (8.7%), p = 0.8 | (37) |
| Increase in CRP levels [difference between baseline and day 7 (95% CI)], drug vs. placebo | 27 (8.6–45) vs. 68 (45–90), p = 0.006 |
*Recruitment stopped by the independent data monitoring committee due to futility of including further patients. OR, odds ratio; RR, risk ratio; SGLT-2, sodium-glucose cotransporter 2; CRP, C-reactive protein.