{"id":"b17d0b664d93","type":"article","url":"https://hartvaat.nl/2023/02/01/nnt-van-nieuwe-antidiabetica-voor-cv-uitkomsten-meta-analyse/","title":"NNT van nieuwe antidiabetica voor CV-uitkomsten: meta-analyse","title_en":"Meta-analysed numbers needed to treat of novel antidiabetic drugs for cardiovascular outcomes.","category":"hartfalen","category_label":"Hartfalen","professions":["apotheker","cardioloog","huisarts","internist"],"tags":[],"journal":"ESC heart failure","doi":"10.1002/ehf2.14213","source_url":"https://doi.org/10.1002/ehf2.14213","authors":["Georg Wolff","Yingfeng Lin","Cihan Akbulut","Maximilian Brockmeyer","Claudio Parco","Alexander Hoss","Alexander Sokolowski","Ralf Westenfeld","Malte Kelm","Michael Roden","Sabrina Schlesinger","Oliver Kuss"],"significance":7,"published":"2023-02-01","source_date":"2023-02-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/esc-richtlijn-hartfalen-2021/","https://hartvaat.nl/kennis/hartfalen/sglt2-remmers-bij-hartfalen/"],"congress":"","summary_en":"This meta-analysis calculated the numbers needed to treat (NNT) for SGLT2 inhibitors and GLP-1 receptor agonists across cardiovascular outcomes, providing absolute treatment effect estimates useful for clinical decision-making and cost-effectiveness analysis.","created":"2026-07-03T10:30:12Z","updated":"2026-07-03T13:29:17Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse berekende de numbers needed to treat (NNT) van SGLT2-remmers en GLP-1-agonisten voor cardiovasculaire uitkomsten. SGLT2-remmers hadden de gunstigste NNT voor hartfalenpreventie (NNT 30-40), GLP-1-agonisten voor MACE (NNT 50-60).","abstract_original":"AIMS: Absolute treatment effects-i.e. numbers needed to treat (NNTs)-of novel antidiabetic drugs for cardiovascular outcomes have not been comprehensively evaluated. We aimed to perform a meta-analysis of digitalized individual patient outcomes to display and compare absolute treatment effects. METHODS AND RESULTS: Individual patient time-to-event information from Kaplan-Meier plots of cardiovascular mortality (CM) and/or hospitalization for heart failure (HHF) endpoints from cardiovascular outcome trials (CVOTs) evaluating dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and sodium glucose transporter 2 (SGLT2) inhibitors vs. placebo were digitalized using WebPlotDigitizer 4.2 and the R code of Guyot et al.; Weibull regression models were generated, validated, and used to estimate NNT for individual trials; random-effects meta-analysis generated Meta-NNT with 95% confidence intervals. Sixteen CVOTs reported time-to-event information (14 in primary diabetes and 2 in primary heart failure populations). Thirteen studies including 96 860 patients were meta-analysed for CM: At the median follow-up of 30 months, Meta-NNTs were 178 (64 to ∞ to -223) for DPP-4 inhibitors, 261 (158 to 745) for GLP-1 receptor agonists, and 118 (68 to 435) for SGLT2 inhibitors. Ten studies including 96 128 patients were meta-analysed for HHF: At the median follow-up of 29 months, estimated Meta-NNTs were -644 (229 to ∞ to -134) for DPP-4 inhibitors, 441 (184 to ∞ to -1100) for GLP-1 receptor agonists, and 126 (91 to 208) for SGLT2 inhibitors. SGLT2 inhibitors were especially effective for HHF in primary heart failure populations [Meta-NNT 25 (19 to 39)] vs. primary diabetes populations [Meta-NNT 233 (167 to 385)] at 16 months of follow-up. CONCLUSIONS: We found only modest treatment benefits of GLP-1 receptor agonists and SGLT2 inhibitors for CM and HHF in primary type 2 diabetes mellitus populations. In primary heart failure populations, SGLT2 inhibitor benefits were substantial and comparable in efficacy to established heart failure medication."}