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学科主题: 临床医学
题名:
Comparison of GLP-1 Analogues versus Sitagliptin in the Management of Type 2 Diabetes: Systematic Review and Meta-Analysis of Head-to-Head Studies
作者: Wang, Tiansheng1,4; Gou, Zhuoyue2; Wang, Fei3; Ma, Manling2; Zhai, Suo-di4
刊名: PLOS ONE
发表日期: 2014-08-04
DOI: 10.1371/journal.pone.0103798
卷: 9, 期:8
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Multidisciplinary Sciences
研究领域[WOS]: Science & Technology - Other Topics
关键词[WOS]: GLUCAGON-LIKE PEPTIDE-1 ; DIPEPTIDYL PEPTIDASE-4 INHIBITORS ; RANDOMIZED CONTROLLED-TRIALS ; RECEPTOR AGONISTS ; DPP-4 INHIBITORS ; POSTPRANDIAL GLUCOSE ; CLINICAL-TRIALS ; EXENATIDE ; EFFICACY ; SAFETY
英文摘要:

Background: Incretin-based therapies which include glucagon-like peptide-1 (GLP-1) receptor agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors are recommended by several practice guidelines as second-line agents for add-on therapy to metformin in patients with type 2 diabetes (T2DM) who do not achieve glycemic control with metformin plus lifestyle interventions alone. The purpose of this study is to perform a systematic review with meta-analysis of existing head to head studies to compare the efficacy and safety of GLP-1 analogues with DPP-4 inhibitors.

Methods: We performed a systematic review and meta-analysis of head-to-head studies to compare GLP-1 analogues with DPP-4 inhibitors in the management of type 2 diabetes. A random effects model was selected to perform the meta-analyses, results were expressed as weighted mean differences for continuous outcomes and relative risks for dichotomous outcomes, both with 95% confidence intervals, and with I-2 values and P values as markers of heterogeneity.

Results: Four head-to-head randomized controlled studies with 1755 patients were included. Compared to sitagliptin, GLP-1 analogues are more effective in reducing HbA1C (weight mean difference -0.41%, 95% CI -0.51 to -0.31) and body weight (weight mean difference -1.55 kg, 95% CI -1.98 to -1.12). Conversely, GLP-1 analogues are associated with a higher incidence of gastrointestinal adverse events compared to sitagliptin: nausea (relative risk 3.14, 95% CI 2.15 to 4.59), vomiting (relative risk 2.60, 95% CI 1.48 to 4.56), diarrhea (relative risk 1.82, 95% CI 1.24 to 2.69), and constipation (relative risk 2.50, 95% CI 1.33 to 4.70).

Conclusions: The result of this meta-analysis demonstrates that compared to sitagliptin, GLP-1 analogues are more effective for glycemic control and weight loss, but have similar efficacy in reducing blood pressure and lipid parameters, however, GLP-1 analogues are associated with a higher incidence of gastrointestinal adverse events and a similar incidence of hypoglycemia compared to sitagliptin.

语种: 英语
WOS记录号: WOS:000339812700056
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/55298
Appears in Collections:北京大学第三临床医学院_药剂科_期刊论文

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作者单位: 1.Peking Univ, Dept Pharm, Hosp 3, Beijing 100871, Peoples R China
2.Peking Univ, Hlth Sci Ctr, Dept Pharm Adm & Clin Pharm, Beijing 100871, Peoples R China
3.Harbin Med Univ, Affiliated Hosp 1, Dept Pharm, Harbin, Peoples R China
4.Univ Connecticut, Sch Pharm, Dept Pharm Practice, Storrs, CT USA

Recommended Citation:
Wang, Tiansheng,Gou, Zhuoyue,Wang, Fei,et al. Comparison of GLP-1 Analogues versus Sitagliptin in the Management of Type 2 Diabetes: Systematic Review and Meta-Analysis of Head-to-Head Studies[J]. PLOS ONE,2014,9(8).
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