Table 3.

Summary of findings from the systematic review with Bayesian hierarchical network meta‐analysis by Zheng and colleagues74

Feature	Details
Population	T2DM
Intervention	SGLT2‐Is
Comparator	GLP‐1 RAs, DPP4‐Is, placebo or no treatment
CV outcome(s)	CVM, ACM, HF events, MI and unstable angina
Study	Network MA of 236 RCTs ≥12 weeks
Key results (efficacy)	CVM = SGLT2‐Is vs. DPP4‐Is: 0.79 (0.66–0.94); SGLT2‐Is vs. GLP‐1 RAs: 0.93 (0.78–1.10) ACM = SGLT2‐Is vs. DPP4‐Is: 0.78 (0.68–0.90), SGLT2‐Is vs. GLP‐1 RAs: 0.91 (0.79–1.04)
Key results (safety)	No difference between drug classes for any or major hypoglycaemia. SGLT2‐Is were associated with reduction in serious adverse events compared to all other controls, whereas GLP‐1 RAs were associated with increased risk of adverse events leading to trial withdrawal compared with the control groups
Risk of bias	Risk of attrition bias in 25% of studies. Two out of studies comparing SGLT2Is vs. DPP4‐Is were rated with unclear risk of bias for at least two domains
Notes	Low heterogeneity, consistency of results across analyses (frequentist and Bayesian approaches) Breakdown of direct and indirect evidence Data at the individual drug level
Limitations	Only one study compared head‐to‐head SGLT2‐Is vs. GLP‐1 RAs, and three or four studies SGLT2‐Is vs. DPP4‐Is (ACM and CVM, respectively) Statistically significant inconsistency within the network (i.e. ratio between direct and indirect evidence) for some events (e.g. HF), mainly with DPP4‐Is

ACM, all‐cause mortality; CV, cardiovascular; CVM, cardiovascular mortality; DPP4‐Is, dipeptidyl peptidase‐4 inhibitors; GLP‐1RA, glucagon‐like peptide‐1 receptor agonist; HF, heart failure; MI, myocardial infarction; RCTs, randomized clinical trials; SGLT2‐Is, sodium glucose co‐transporter‐2 inhibitors.