Effects Of Empagliflozin On Renal Function In Patients With Type 2 Diabetes:a Systematic Review And Meta-analysis

Objective To evaluate the effects of empagliflozin on renal funct ion in patients with type 2 diabetes.Methods We searched Keywords and the MeSH joint free word respectively,according to the characteristics of different databases,witho ut language restrictions.We searched Pubmed,EMBASE,the Cochrane Libray,CNKI,WANFANG Database,VIP,from inception to October 2017.Two reviewers independently screened the studies for eligibility,extracte d the data from the eligible studies,with the confirmation of cross-check.Collected published both at home and abroad about empagliflozin in pa tients with type 2 diabetes effects of randomized Controlled Trials(RC T)in both English and Chinese.Statistical analysis was performed by th e RevMan5.3 software of Cochrane Collaboration.Results Seventeen randomized,double-blind,controlled trials involv ing 18707 patients with type 2 diabetes mellitus were included.The pub lished language of included trials was English.The included trials period was ranged from 4 weeks to 192 weeks.The meta-analysis results of effectiveness indicated that empagliflozin produced less effective than pl acebo in decreasing eGFR[P<0.00001,WMD=-1.62,95%CI(-2.21,-1.03)].According to the subgroup analysis of treatment time.When the tr eatment was less than 52 weeks,the decreasing eGFR of the patients in the test group and the control group was not obvious,and the results s howed no significant difference [P=0.18,WMD=-0.83,95%CI(-2.03,0.38)].After the treatment time was more than 52 weeks,the decreasing eGFR in patients with type 2 diabetes was less than that in the control group[P<0.00001,WMD=-1.87,95%CI(-2.54,-1.19)].In blood pressur e,the systolic blood pressure and diastolic blood pressure of empaglifloz in group decreased significantly compared to placebo[P<0.00001,WM D=2.89,95%CI(2.38,3.40)],[P<0.00001,WMD=1.43,95%CI(0.99,1.86)].Empagliflozin significantly decreased the body weight,compared with placebo[P<0.00001,WMD=1.80,95%CI(1.77,1.82)].Conclusions 1.The empagliflozin can effectively delay the decli ne of eGFR in type 2 diabetes.2.Empagliflozin can reduce body weig ht and has a certain antihypertensive effect.