Patient-centred outcomes with incretin-based therapies and sodium-glucose cotransporter 2 inhibitors in obesity-related heart failure with preserved ejection fraction: a programme-level systematic review and meta-analysis

Abstract Background: Obesity-related heart failure with preserved ejection fraction is characterised by symptom burden, impaired mobility, and reduced health status. Direct comparative evidence between incretin-based therapies and sodium-glucose cotransporter 2 inhibitors is lacking.

Methods

We conducted a PRISMA-guided systematic review and programme-level meta-analysis, using the independent parent randomised trial programme as the unit of analysis to avoid double-counting linked reports. The primary endpoint was the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score, and the secondary endpoint was the six-minute walk distance. Random-effects models used restricted maximum likelihood estimation with Knapp-Hartung inference.