Comparative effectiveness of dipeptidylpeptidase-4 inhibitors in type 2 diabetes: a systematic review and mixed treatment comparison.
Comparative effectiveness of dipeptidylpeptidase-4 inhibitors in type 2 diabetes: a systematic review and mixed treatment comparison.
复制标题
DOI：
10.1007/s13300-014-0061-3
复制
发表时间：
2014-06
期刊：
影响因子：
3.8
通讯作者：
Johnson, K. Ian
中科院分区：
文献类型：
--
作者：
Craddy, Paul;Palin, Hannah-Jayne;Johnson, K. Ian
关键词：
比较二肽基肽酶 4 (DPP-4) 抑制剂在血糖控制不足的 2 型糖尿病患者中的安全性和有效性。对随机对照试验（RCT）、健康经济评估研究、系统评价和荟萃分析进行系统评价，然后进行初级贝叶斯混合治疗比较荟萃分析（MTC），以及使用随机效应模型的二级频率论直接比较荟萃分析。结果报告为相对于基线的加权平均变化，或具有 95% 可信区间的优势比 (OR)。 MEDLINE、MEDLINE In-Process、EMBASE 和 BIOSIS（通过 Dialog ProQuest）；通过 EBSCO 进行的 Cochrane 对照试验中央注册库和 Cochrane 系统评价数据库；四份糖尿病摘要和两份技术会议摘要；和卫生技术评估组织网站。患有 2 型糖尿病且血糖控制不足且正在接受任何药物抗糖尿病治疗的患者。对标题/摘要进行资格审查，然后对第一次通过后剩余的出版物进行全文审查。由三人团队过滤文章，由独立审稿人检查随机选择 (10%) 的过滤文章。研究的数据提取和质量评估也经过独立审查。通过荟萃分析（在有数据的情况下）对五种 DPP-4 抑制剂（阿格列汀、利格列汀、沙格列汀、西格列汀和维格列汀）作为单一疗法、双重疗法（加二甲双胍、磺酰脲类、吡格列酮或胰岛素）和三联疗法（加二甲双胍/磺酰脲类）进行比较。审查确定了 6,601 篇文章； 163 篇文章符合纳入标准，83 项随机对照试验中的 85 篇出版物包含足够或适当的数据进行分析。 MTC 表明，DPP-4 抑制剂之间的糖化血红蛋白 (HbA1c) 或体重相对于基线的平均变化，或者达到 HbA1c <7% 或经历低血糖事件的患者比例没有差异，但使用阿格列汀加二甲双胍治疗的患者除外，与接受沙格列汀加二甲双胍治疗的患者相比，这些患者实现 HbA1c <7% 的频率更高 [OR 6.41 (95% CI 3.15–11.98) 对比 2.17 (95% CI 1.56–2.95)]。这项系统评价和 MTC 显示，无论是作为单一疗法还是联合疗法，DPP-4 抑制剂作为 2 型糖尿病治疗的疗效和安全性相似。本文的在线版本 (doi:10.1007/s13300-014-0061-3) 包含补充材料，可供授权用户使用。
To compare the safety and efficacy of the dipeptidylpeptidase-4 (DPP-4) inhibitors in patients with type 2 diabetes and inadequate glycemic control. Systematic review of randomized controlled trials (RCTs), health economic evaluation studies, systematic reviews, and meta-analyses, followed by primary Bayesian mixed treatment comparison meta-analyses (MTCs), and secondary frequentist direct-comparison meta-analyses using a random-effects model. Outcomes were reported as weighted mean change from baseline, or odds ratio (OR) with 95% credible interval. MEDLINE, MEDLINE In-Process, EMBASE, and BIOSIS via Dialog ProQuest; Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews via EBSCO; four diabetes and two technical congress abstracts; and health technology assessment organization websites. Patients with type 2 diabetes and inadequate glycemic control receiving any pharmacological anti-diabetic treatment. Title/abstracts were reviewed for eligibility, followed by full-text review of publications remaining after first pass. A three-person team filtered articles and an independent reviewer checked a random selection (10%) of filtered articles. Data extraction and quality assessment of studies were also independently reviewed. Five DPP-4 inhibitors (alogliptin, linagliptin, saxagliptin, sitagliptin, and vildagliptin) were compared via meta-analysis (where data were available) as monotherapy, dual therapy (plus metformin, sulfonylurea, pioglitazone, or insulin), and triple therapy (plus metformin/sulfonylurea). The review identified 6,601 articles; 163 met inclusion criteria and 85 publications from 83 RCTs contained sufficient or appropriate data for analysis. MTCs demonstrated no differences between DPP-4 inhibitors in mean change from baseline in glycosylated hemoglobin (HbA1c) or body weight, or the proportions of patients achieving HbA1c <7% or experiencing a hypoglycemic event, apart from in patients on alogliptin plus metformin, who achieved HbA1c <7% more frequently than those treated with saxagliptin plus metformin [OR 6.41 (95% CI 3.15–11.98) versus 2.17 (95% CI 1.56–2.95)]. This systematic review and MTC showed similar efficacy and safety for DPP-4 inhibitors as treatment for type 2 diabetes, either as monotherapy or combination therapy. The online version of this article (doi:10.1007/s13300-014-0061-3) contains supplementary material, which is available to authorized users.
登录
查看更多内容
影响因子：
5.8
作者：
Bosi, E.;Dotta, F.;Goodman, M.
通讯作者：
Goodman, M.
影响因子：
5.8
作者：
Blonde, L.;Dagogo-Jack, S.;Baron, M.
通讯作者：
Baron, M.
影响因子：
5.8
作者：
DeFronzo, R. A.;Burant, C. F.;Pratley, R. E.
通讯作者：
Pratley, R. E.
影响因子：
5.8
作者：
Del Prato, S.;Barnett, A. H.;Dugi, K. A.
通讯作者：
Dugi, K. A.
影响因子：
16.2
作者：
Bosi, Emanuele;Camisasca, Riccardo Paolo;Garber, Alan J.
通讯作者：
Garber, Alan J.