Glucagon-like peptide analogues for type 2 diabetes mellitus: systematic review and meta-analysis.
Glucagon-like peptide analogues for type 2 diabetes mellitus: systematic review and meta-analysis.
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DOI：
10.1186/1472-6823-10-20
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发表时间：
2010-12-09
影响因子：
2.7
通讯作者：
Waugh NR
中科院分区：
文献类型：
--
作者：
Shyangdan DS;Royle PL;Clar C;Sharma P;Waugh NR
胰高血糖素样肽（GLP-1）类似物是一类用于治疗2型糖尿病的新药。它们通过注射给予，并通过刺激葡萄糖依赖性胰岛素分泌和生物合成、抑制胰高血糖素分泌、延迟胃排空和促进饱腹感来调节葡萄糖水平。本系统性综述旨在提供GLP-1激动剂在使用一种或多种口服降糖药物后血糖控制不佳的患者中的临床有效性证据。检索MEDLINE、EMBASE、科克伦图书馆和Web of Science，查找相关文献。我们确定了28项随机对照试验，比较GLP-1类似物与安慰剂、其他降糖药或另一种GLP-1类似物在单一口服药物或双重治疗控制不佳的2型糖尿病患者中的作用。主要结局包括HbA 1c、体重变化和不良事件。研究大多持续时间较短，通常为26周。与安慰剂相比，所有GLP-1激动剂均使HbA 1c降低约1%。艾塞那肽每日两次和胰岛素对HbA 1c的降低作用相似，但艾塞那肽2 mg每周一次和利拉鲁肽1.8 mg每日一次的降低作用分别比甘精胰岛素高0.20%和0.30%。利拉鲁肽1.2 mg每日一次使HbA 1c降低0.34%，高于西格列汀100 mg每日一次。艾塞那肽和利拉鲁肽对HbA 1c的改善与磺脲类药物相似。艾塞那肽2 mg每周一次和利拉鲁肽1.8 mg每日一次降低HbA 1c的幅度超过艾塞那肽10 μg每日两次和西格列汀100 mg每日一次。艾塞那肽2 mg每周一次比吡格列酮45 mg每日一次降低HbA 1c 0.3%。艾塞那肽和利拉鲁肽导致的体重减轻（从2.3至5.5 kg）大于活性对照药物。这不仅仅是因为恶心。低血糖症是罕见的，除非与磺脲类药物联合使用。所有GLP-1激动剂最常见的不良事件是初始恶心和呕吐。GLP-1激动剂对β细胞功能有一定影响，但停药后这种影响不会持续。GLP-1激动剂可有效改善血糖控制和促进体重减轻。
Glucagon-like peptide (GLP-1) analogues are a new class of drugs used in the treatment of type 2 diabetes. They are given by injection, and regulate glucose levels by stimulating glucose-dependent insulin secretion and biosynthesis, suppressing glucagon secretion, and delaying gastric emptying and promoting satiety. This systematic review aims to provide evidence on the clinical effectiveness of the GLP-1 agonists in patients not achieving satisfactory glycaemic control with one or more oral glucose lowering drugs. MEDLINE, EMBASE, the Cochrane Library and Web of Science were searched to find the relevant papers. We identified 28 randomised controlled trials comparing GLP-1 analogues with placebo, other glucose-lowering agents, or another GLP-1 analogue, in patients with type 2 diabetes with inadequate control on a single oral agent, or on dual therapy. Primary outcomes included HbA1c, weight change and adverse events. Studies were mostly of short duration, usually 26 weeks. All GLP-1 agonists reduced HbA1c by about 1% compared to placebo. Exenatide twice daily and insulin gave similar reductions in HbA1c, but exenatide 2 mg once weekly and liraglutide 1.8 mg daily reduced it by 0.20% and 0.30% respectively more than glargine. Liraglutide 1.2 mg daily reduced HbA1c by 0.34% more than sitagliptin 100 mg daily. Exenatide and liraglutide gave similar improvements in HbA1c to sulphonylureas. Exenatide 2 mg weekly and liraglutide 1.8 mg daily reduced HbA1c by more than exenatide 10 μg twice daily and sitagliptin 100 mg daily. Exenatide 2 mg weekly reduced HbA1c by 0.3% more than pioglitazone 45 mg daily. Exenatide and liraglutide resulted in greater weight loss (from 2.3 to 5.5 kg) than active comparators. This was not due simply to nausea. Hypoglycaemia was uncommon, except when combined with a sulphonylurea. The commonest adverse events with all GLP-1 agonists were initial nausea and vomiting. The GLP-1 agonists have some effect on beta-cell function, but this is not sustained after the drug is stopped. GLP-1 agonists are effective in improving glycaemic control and promoting weight loss.
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影响因子：
16.2
作者：
Davis, Stephen N.;Johns, Don;Brodows, Robert G.
通讯作者：
Brodows, Robert G.
影响因子：
4.8
作者：
Farilla, L;Bulotta, A;Perfetti, R
通讯作者：
Perfetti, R
影响因子：
5.9
作者：
Apovian, Caroline M.;Bergenstal, Richard M.;Glass, Leonard C.
通讯作者：
Glass, Leonard C.
影响因子：
8.2
作者：
Butler, P. C.;Matveyenko, A. V.;Dry, S.;Bhushan, A.;Elashoff, R.
通讯作者：
Elashoff, R.
影响因子：
5.8
作者：
Davies, M. J.;Donnelly, R.;Kilcoyne, A.
通讯作者：
Kilcoyne, A.