Efficacy and Side Effect Profile of Different Formulations of Metformin: A Systematic Review and Meta-Analysis.
Efficacy and Side Effect Profile of Different Formulations of Metformin: A Systematic Review and Meta-Analysis.
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DOI：
10.1007/s13300-021-01058-2
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Aiken CE
中科院分区：
文献类型：
--
作者：
Tarry-Adkins JL;Grant ID;Ozanne SE;Reynolds RM;Aiken CE
二甲双胍是全世界最常用于各种适应症的处方药之一。尽管二甲双胍具有几个重要的优点，例如易于储存和给药，但它与胃肠道副作用的高发生率相关。二甲双胍缓释制剂可在维持疗效的同时降低副作用的发生率;然而，缺乏系统性证据可用于指导不同二甲双胍制剂之间的头对头比较。系统检索了PubMed、Web of Science、奥维德EMBASE、MEDLINE、科克伦数据库和Clinicaltrials.gov（从开始到2021年1月25日）。纳入了将成人受试者随机分配至二甲双胍缓释制剂（met-XR）、延迟释放制剂（met-DR）或速释制剂（met-IR）的试验。两名评审员独立评估文章的合格性和偏倚风险，由第三名评审员解决冲突。结果指标包括空腹血糖（FPG）、糖化血红蛋白（HbA 1c）、体重、BMI、血脂和副作用的变化。采用随机效应模型进行荟萃分析。15项研究（n = 3765）符合合格性标准。met-IR、met-XR或met-DR在改变FPG方面的疗效无显著差异（p = 0.93）。在随机分配至met-XR组与met-IR组的个体中观察到平均体重无显著性降低（− 1.03 kg，95% CI − 2.12至0.05，p = 0.06）。随机分配至met-XR组与met-IR组的个体低密度脂蛋白（LDL）胆固醇水平较低（− 5.73 mg/dl，95% CI − 7.91至− 3.56，p < 0.00001）。在随机分配至met-DR与met-IR的患者中，胃肠道（GI）副作用显著降低（OR 0.45，95% CI 0.26-0.80，p = 0.006）。我们的研究结果表明长效制剂（met-XR，met-DR）与速释二甲双胍制剂在血药控制方面具有相同的疗效。没有足够的研究来比较不同二甲双胍制剂在糖尿病治疗之外的疗效。然而，met-XR与降低血清LDL胆固醇浓度相关，而met-DR与降低GI副作用密切相关，这可以改善药物依从性。在线版本包含补充材料，可通过10.1007/s13300-021-01058-2获得。
Metformin is among the most frequently prescribed drugs worldwide for a variety of indications. Although metformin has several important advantages, for example being easy to store and administer, it is associated with a high incidence of gastrointestinal side effects. Slower-release formulations of metformin may reduce the incidence of side effects while maintaining efficacy; however, there is a lack of systematic evidence available to guide head-to-head comparisons between different metformin formulations. PubMed, Web of Science, OVID EMBASE, MEDLINE, The Cochrane database and Clinicaltrials.gov were systematically searched (from inception to 25 January 2021). Trials that randomized adult participants to extended-release formulation of metformin (met-XR), delayed-release (met-DR) or immediate-release metformin (met-IR) were included. Two reviewers independently assessed articles for eligibility and risk-of-bias, with conflicts resolved by a third reviewer. Outcome measures were change in fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), body weight, BMI, lipid profile and side effects. Meta-analyses were conducted using random-effects models. Fifteen studies (n = 3765) met eligibility criteria. There was no significant difference between the efficacy of met-IR, met-XR or met-DR in changing FPG (p = 0.93). A non-significant reduction in mean body weight was observed in individuals randomized to met-XR vs. met-IR (− 1.03 kg, 95% CI − 2.12 to 0.05, p = 0.06). Individuals randomized to met-XR vs. met-IR had lower low-density lipoprotein (LDL) cholesterol levels (− 5.73 mg/dl, 95% CI − 7.91 to − 3.56, p < 0.00001). Gastrointestinal (GI) side effects were markedly reduced in patients randomised to met-DR vs. met-IR (OR 0.45, 95% CI 0.26–0.80, p = 0.006). Our results demonstrate equal efficacy of longer-acting formulations (met-XR, met-DR) versus immediate-release metformin formulations in terms of glycaemic control. There were insufficient studies available to compare the efficacy of different metformin formulations outside of diabetes care. However met-XR was associated with reduced serum LDL cholesterol concentrations, while met-DR was strongly associated with reduced GI side effects, which could improve drug compliance. The online version contains supplementary material available at 10.1007/s13300-021-01058-2.
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影响因子：
4.4
作者：
Ramsdell, JW;Braunstein, SN;Devine, ST
通讯作者：
Devine, ST
影响因子：
4.4
作者：
Levri, KM;Slaymaker, E;Wilson, SA
通讯作者：
Wilson, SA
影响因子：
4.8
作者：
El-Mir, MY;Nogueira, V;Leverve, X
通讯作者：
Leverve, X
二甲双胍：风湿病学家的潜在治疗工具。
DOI：
10.3390/ph13090234
发表时间：
2020-09-04
期刊：
Pharmaceuticals (Basel, Switzerland)
影响因子：
--
作者：
Salvatore T;Pafundi PC;Galiero R;Gjeloshi K;Masini F;Acierno C;Di Martino A;Albanese G;Alfano M;Rinaldi L;Sasso FC
通讯作者：
Sasso FC
DOI：
10.1111/j.1742-1241.2008.01733.x
发表时间：
2008-05-01
影响因子：
2.6
作者：
Gao, H.;Xiao, W.;Hong, T.
通讯作者：
Hong, T.