Effect of anti-inflammatory therapy on major cardiovascular events in patients with diabetes: A meta-analysis

Diabetes Metab Syndr. 2021 Jul-Aug;15(4):102164. doi: 10.1016/j.dsx.2021.06.001. Epub 2021 Jun 5.

Abstract

Background: In patients with coronary artery disease anti-inflammatory drugs have been shown to be effective in reducing cardiovascular events. The effect of this intervention in the population with type 2 diabetes mellitus (T2DM) is poorly explored. The main objective of this study was to evaluate the effect of anti-inflammatory therapy on the incidence of major cardiovascular events (MACE) in patients with T2DM.

Methods: A meta-analysis of randomized studies that evaluated the use of anti-inflammatory therapy in patients with T2DM and reported MACE was performed, after searching the PubMed/MEDLINE, Embase, Scielo, Google Scholar and Cochrane Controlled Trials databases. A fixed or random effects models were used.

Results: Five studies were selected for the analysis (2075 subjects in the anti-inflammatory therapy arm and 2490 patients in the placebo/control arm). All studies included patients with T2DM and history of coronary artery disease. Four studies evaluated the use of colchicine and one of them canakinumab. The use of anti-inflammatory therapy was associated with a lower risk of MACE (HR: 0.80; 95% CI, 0.69-0.93; I2 = 24%). The sensitivity analysis shows that the results are robust.

Conclusion: This meta-analysis demonstrated that the use of anti-inflammatory therapy in patients with T2DM and atherosclerotic cardiovascular disease was associated with reduced risk of MACE. These results suggest the need to consider the inflammatory pathway as a potential therapeutic target in patients with T2DM.

Keywords: Anti-Inflammatory therapy; Canakinumab; Colchicine; Diabetes; Major cardiovascular events.

Publication types

  • Meta-Analysis

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use*
  • Cardiovascular Diseases / epidemiology*
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Humans
  • Interleukin-1beta
  • Interleukin-6
  • NLR Family, Pyrin Domain-Containing 3 Protein
  • Randomized Controlled Trials as Topic

Substances

  • Anti-Inflammatory Agents
  • IL1B protein, human
  • IL6 protein, human
  • Interleukin-1beta
  • Interleukin-6
  • NLR Family, Pyrin Domain-Containing 3 Protein
  • NLRP3 protein, human