The effect and safety of diacerein in patients with type 2 diabetes mellitus : a systematic review and meta-analysis.
The effect and safety of diacerein in patients with type 2 diabetes mellitus : a systematic review and meta-analysis.
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发表时间：
2017
影响因子：
0.8
通讯作者：
Qi Zhang;Junteng Zhou;Yushu Wang;Decai Chen
中科院分区：
文献类型：
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作者：
Qi Zhang;Junteng Zhou;Yushu Wang;Decai Chen
背景：双醋瑞因具有抗炎作用，已被推荐作为2型糖尿病的治疗选择。目的这项随机对照试验（RCT）的系统性综述和荟萃分析的目的是检查双醋瑞因在2型糖尿病患者中的效果和安全性。数据来源和研究选择我们检索了Pubmed、Embase和科克伦图书馆，以查找从数据库建立到2017年9月发表的RCT。在最初确定的44项研究中，有4项符合条件，并被纳入以下分析。双醋瑞因显著降低空腹血糖[加权平均差异（WMD）-0.66，95%置信区间（95% CI）-1.16至-0.16]和糖化血红蛋白A1 c（HbA 1c）（WMD-0.85，95% CI -1.44至-0.26）。补充双醋瑞因时间≤12周的患者空腹血糖和HbA 1c下降幅度大于补充时间>12周的患者。与安慰剂组相比，双醋瑞因组胃肠道症状的相对危险度（RR）显著增加（RR=2.50，95%CI：1.10 ~ 5.65），尤其是在补充时间>12周的研究亚组（RR=4.01，95%CI：2.32 ~ 6.95）。局限性由于纳入研究的样本量相对较小，研究持续时间较短，因此较长时间内的治疗疗效和安全性尚不清楚。结论：虽然还需要进一步的研究，我们的研究结果清楚地支持在2型糖尿病患者的临床管理中使用双醋瑞因。
The Background: Diacerein has been proposed as a treatment option for management of type 2 diabetes due to its anti-inflammatory properties. PURPOSE The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) is to examine the effect and safety of diacerein in patients with type 2 diabetes. DATA SOURCES AND STUDY SELECTION We searched Pubmed, Embase, and Cochrane Library for RCTs published from database inception to September 2017. DATA EXTRACTION AND DATA SYNTHESIS Among 44 studies that were initially identified, four were eligible and were included in the following analysis. Diacerein significantly reduced fasting glycemia [weighted mean differences (WMD) -0.66, 95% confidence interval (95% CI) -1.16 to -0.16] and glycated hemoglobin A1c (HbA1c ) (WMD -0.85, 95% CI -1.44 to -0.26). And the patients with a diacerein supplementation duration of ≤12 weeks had a greater decrease of fasting glycemia and HbA1c than the supplementation duration of >12 weeks. Furthermore, compared with placebo, diacerein revealed a significant increase in the relative risk (RR) of gastrointestinal symptoms (RR=2.50, 95% CI: 1.10 to 5.65), especially in the study subgroup with supplementation duration of >12 weeks (RR=4.01, 95% CI: 2.32 to 6.95). LIMITATIONS The sample size was relatively small and the duration of included studies was short so that the treatment efficacy and safety for longer duration was unknown. CONCLUSIONS Although further studies are needed, our findings clearly provide support to the use of diacerein in the clinical management of subjects with type 2 diabetes.