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Efficacy outcomes focused on glycated haemoglobin (HbA1c) reduction, fasting plasma glucose (FPG) reduction and weight loss (WL). Safety outcomes included adverse events (AEs), serious AEs (SAEs), hypoglycaemia, urinary tract infections (UTI) and genital infections (GI).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Data extraction and synthesis<\/jats:title>\n<jats:p>Two investigators independently extracted data. The quality of the included studies was assessed using the Cochrane Risk of Bias Tool (V.2.0) for RCTs.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>23 RCTs involving 9144 patients and 11 SGLT2is were included. Compared with placebo, most SGLT2is reduced HbA1c (mean difference (MD), \u22120.45~\u22120.80%), FPG (MD, \u22120.78~\u22122.02\u2009mmol\/L) and body weight (MD, \u22120.88~\u22122.67\u2009kg). Only 10\u2009mg of henagliflozin increased the incidence of AEs, and none of the included interventions increased the risks of SAEs or UTIs. 50\u2009mg of empagliflozin exhibited higher risks of hypoglycaemia. Only 10\u2009mg of empagliflozin increased the risk of GI. According to the surface under the cumulative ranking values, SGLT2is with optimal efficacy and safety were 15\u2009mg of ertugliflozin in HbA1c reduction, 300\u2009mg of canagliflozin in FPG reduction, WL and hypoglycaemia, 400\u2009mg of sotagliflozin in total AEs, 10\u2009mg of ertugliflozin and 150 mg of ipragliflozin in SAEs, 12.5\u2009mg of ipragliflozin in UTI and 1\u2009mg of ertugliflozin in GI.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>As add-on therapy, SGLT2is demonstrated favourable antidiabetic efficacy and acceptable safety. 300\u2009mg of canagliflozin was the best option among the included interventions considering favourable glucose control and WL. Some novel SGLT2is (eg, henagliflozin) exhibited promising efficacy and safety profiles, but more research is needed to validate the findings.<\/jats:p>\n<\/jats:sec>","DOI":"10.1136\/bmjopen-2024-088687","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T10:24:48Z","timestamp":1740565488000},"page":"e088687","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Efficacy and safety of 11 sodium-glucose cotransporter-2 inhibitors at different dosages in type 2 diabetes mellitus patients inadequately controlled with metformin: a Bayesian network meta-analysis"],"prefix":"10.1136","volume":"15","author":[{"given":"Leqing","family":"Xu","sequence":"first","affiliation":[{"name":"Fudan University, Shanghai, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yike","family":"Wu","sequence":"additional","affiliation":[{"name":"Fudan University, Shanghai, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiyifan","family":"Li","sequence":"additional","affiliation":[{"name":"Fudan University, Shanghai, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanan","family":"Ding","sequence":"additional","affiliation":[{"name":"Fudan University, Shanghai, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junwei","family":"Chow","sequence":"additional","affiliation":[{"name":"Fudan University, Shanghai, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longzhou","family":"Li","sequence":"additional","affiliation":[{"name":"Fudan University, Shanghai, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyang","family":"Liu","sequence":"additional","affiliation":[{"name":"Fudan University, Shanghai, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihan","family":"Wang","sequence":"additional","affiliation":[{"name":"Fudan University, Shanghai, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Gong","sequence":"additional","affiliation":[{"name":"Fudan University, Shanghai, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Li","sequence":"additional","affiliation":[{"name":"Shanghai Fifth People\u2019s Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5524-7172","authenticated-orcid":false,"given":"Guo","family":"Ma","sequence":"additional","affiliation":[{"name":"Fudan University, Shanghai, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"2025070104270836000_15.2.e088687.1","unstructured":"Home, Resources, diabetes L with . 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