Dipeptydil peptidase-4 inhibitors in type 2 diabetes: A meta-analysis of randomized clinical trials
Dipeptydil peptidase-4 inhibitors in type 2 diabetes: A meta-analysis of randomized clinical trials
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DOI：
10.1016/j.numecd.2009.03.015
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发表时间：
2010-05-01
影响因子：
3.9
通讯作者：
Mannucci, E.
中科院分区：
文献类型：
--
作者：
Monami, M.;Iacomelli, I.;Mannucci, E.
背景和目的：二肽基肽酶-4（DPP-4）抑制剂在2型糖尿病治疗中的作用存在争议;许多最近的试验，没有包括在以前的荟萃分析中，可以添加相关信息。方法和结果：所有在使用DPP-4抑制剂的2型糖尿病患者中进行的已发表或未发表的现有随机对照试验（RCT），对持续时间>12周的患者进行HbA 1c、BMI、低血糖和其他不良事件的荟萃分析。共检索到41项RCT（其中9项未发表）并纳入分析。与安慰剂相比，格列汀可显著改善HbA 1c（-0.7 [-0.8：-0.6]），低血糖风险较低。DPP-4抑制剂在单药治疗和与其他药物联合治疗中显示出相似的疗效。DPP-4抑制剂的心血管事件和全因死亡风险分别为0.76 [0.46-1.28]和0.78 [0.40-1.51]。结论：DPP-4抑制剂降低HbA 1c的程度低于磺脲类药物，但无体重增加和低血糖风险;需要进一步数据来评估其长期安全性。(C)2009 Elsevier B. V.保留所有权利。
Background and Aim: The role of Dipeptidyl Peptidase-4 (DPP-4) inhibitors in the treatment of type 2 diabetes is debated; many recent trials, which were not included in previous meta-analyses, could add relevant information.Methods and Results: All available randomized controlled trials (RCTs), either published or unpublished, performed in type 2 diabetic patients with DPP-4 inhibitors, with a duration >12 weeks were meta-analyzed for HbA1c, BMI, hypoglycemia, and other adverse events. A total of 41 RCTs (9 of which are unpublished) was retrieved and included in the analysis. Gliptins determine a significant improvement of HbA1c in comparison with a placebo (-0.7 [-0.8:-0.6]), with a low risk of hypoglycemia. DPP-4 inhibitors show a similar efficacy in monotherapy and in combination with other agents. The risk of cardiovascular events and all-cause death with DPP-4 inhibitors is 0.76 [0.46-1.28] and 0.78 [0.40-1.51], respectively. Conclusions: DPP-4 inhibitors reduce HbA1c, although to a lesser extent than sulphonylureas, with no weight gain and no hypoglycemic risk; further data are needed to assess their long-term safety. (C) 2009 Elsevier B.V. All rights reserved.