SGLT2 Inhibitor Meta-Analysis Cardio-Renal Trialists Consortium (SMART-C)
Our goal
SMART-C aims to directly inform clinical practice and major guidelines that define optimal care for people living with diabetes, cardiovascular and kidney disease by providing reliable and definitive evidence on the effects of SGLT2 inhibitors on key outcomes in major patient groups.
Overview
Sodium-glucose cotransporter 2 (SGLT2) inhibitors represent one of the most important advances in the care of people with cardio-renal-metabolic conditions in the 21st century, with large-scale trials demonstrating that these agents reduce the risk of cardiovascular events and kidney disease progression in people with type 2 diabetes, heart failure or chronic kidney disease.
The SGLT2 Inhibitor Meta-Analysis Cardio-Renal Trialists’ Consortium (SMART-C) was established in 2022 to bring together data from completed SGLT2 inhibitor outcome trials. By aggregating all available evidence from large-scale, placebo-controlled, randomized trials, SMART-C aims to provide definitive evidence on the effects of this important drug class on various outcomes in different types of patients.
About
The SGLT2 Inhibitor Meta-Analysis Cardio-Renal Trialists’ Consortium comprises all completed randomized, double-blind, placebo-controlled, event-driven outcome trials that evaluated the effects of SGLT2 inhibitors in people with type 2 diabetes, heart failure and chronic kidney disease.
By conducting two-stage meta-analyses using harmonised analytical techniques and outcome definitions, SMART-C will address the central unanswered questions about the efficacy and safety of SGLT2 inhibitors in key patient groups. These are questions which cannot be robustly addressed in any individual trial because sample sizes are insufficient, but for which two-stage individual participant data meta-analyses will provide definitive evidence. Aggregating all available randomized evidence will provide reliable estimates of the relative and absolute effects of SGLT2 inhibitors on key outcomes in major patient groups, and this will substantially increase the quality of the recommendations that can be expressed in clinical practice guidelines.
Leadership
SMART-C is led by an independent steering committee featuring key representatives from each of the collaborating trials.
Trials
With over 90,000 patients included in the 13 collaborating trials, SMART-C is the largest data source on SGLT2 inhibitors, comprises all completed large-scale randomized trials.
Publications
The Consortium's work directly informs clinical practice, and has been featured in some of the world's leading general medical and specialty journals such as The Lancet and Circulation.
