- Black patients in clinical trials of new type 2 diabetes (T2D) drugs do not experience cardiovascular disease (CVD) benefits that best placebo.
- Data are from recent trials for glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium glucose co-transporter 2 inhibitors (SGLT-2is) showing significant overall reductions in CVD outcomes.
- Meta-analysis authors say the data are underpowered for definitive conclusions because of underrepresentation of black patients.
Why this matters
- Even though trials included mostly white patients, recent T2D guidelines generalize the results.
- Analysis, pooled data from 11 trials (5 GLP-1RAs, 2 SGLT-2is, 4 dipeptidyl peptidase-4 inhibitors [DPP-4is]); n=102,416 with T2D, 4.5% (n=4601) black.
- Funding: None.
- In pooled results, for black patients, drug vs placebo showed no significant overall difference for (relative risks, 95% CIs):
- Major adverse cardiovascular events (MACEs): 0.94 (0.77-1.16);
- GLP-1RAs: 0.93 (0.66-1.32);
- SGLT-2is: 1.00 (0.47-2.14); or
- DPP-4is: 0.96 (0.71-1.29).
- Across 6 trials showing significant overall MACE reductions, 163 cardiovascular (CV) events occurred among the black patients in treatment groups vs 164 with placebo.
- For black patients in these trials, no significant difference for:
- Drugs vs placebo: 0.97 (0.68-1.39);
- GLP-1RAs: 0.96 (0.61-1.53); or
- SGLT-2is: 1.00 (0.47-2.14).
- 2 eligible trials lacked race data.
- Significant intertrial heterogeneity.