Background: The efficacy and safety of the combination therapy with sodium-glucose cotransporter 2 (SGLT2) inhibitors and angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARBs) in the treatment of type 2 diabetes mellitus (T2DM) was not clear yet.
Research design and methods: A meta-analysis of randomized controlled studies (RCTs) was performed by searching in CENTRAL, Web of Science, PubMed, and Embase.
Results: Eight RCTs involving 6,386 participants were finally enrolled in this meta-analysis. Compared with placebo plus ACEI/ARBs, combined therapy with SGLT2 inhibitors and ACEI/ARBs induced a significant reduction in glycated hemoglobin (HbA1c) level by 0.43% (95% confidence interval [CI]: -0.55, -0.31), fasting plasma glucose level by 16.51 mg/dL (95% CI: -21.94, -11.08); systolic/diastolic blood pressure (BP) by 5.34 mmHg (95% CI: -7.47, -3.21)/1.27 mmHg (95% CI: -1.95, -0.59), respectively; and body weight (BW) by 1.45 kg (95% CI: -2.24, -0.65). Combined therapy was also found to be associated with a lower risk of adverse events. However, a higher risk of genital infections was observed with combination therapy than with placebo.
Conclusions: This combination therapy showed satisfactory effects on lowering glycemic, BW, and BP in the treatment of T2DM patients. The safety of this combination therapy was also acceptable.
Keywords: Sodium-glucose cotransporter 2 inhibitors; angiotensin receptor blockers; angiotensin-converting enzyme inhibitors; combination therapy; type 2 diabetes mellitus.