Differences in the HbA1c‐lowering efficacy of glucagon‐like peptide‐1 analogues between Asians and non‐Asians: a systematic review and meta‐analysis. Issue 10 (15th April 2014)

• Record Type: Journal Article
• Authors: Kim, Y. G.; Hahn, S.; Oh, T. J.; Park, K. S.; Cho, Y. M.
• Is Part Of: Diabetes, obesity & metabolism. Volume 16:Issue 10(2014:Oct.)
• Page Start: 900
• Page End: 909
• Publication Date: 2014-04-15
• Subjects: Diabetes -- Periodicals; Obesity -- Periodicals; Metabolism -- Disorders -- Periodicals; Clinical pharmacology -- Periodicals; 616.462
• DOI: 10.1111/dom.12293
• Languages: English
• ISSNs: 1462-8902

Abstract

<abstract abstract-type="main" id="dom12293-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="dom12293-sec-0001" sec-type="section"> <title>Aims</title> <p id="dom12293-para-0001">To compare the HbA1c‐lowering efficacy of glucagon‐like peptide‐1 (GLP‐1) analogues between Asians and non‐Asians with type 2 diabetes.</p> </sec> <sec id="dom12293-sec-0002" sec-type="section"> <title>Methods</title> <p id="dom12293-para-0002">We searched randomized controlled trials from MEDLINE, EMBASE, LILACS, CENTRAL and <ext-link ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov" xlink:type="simple" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.gov</ext-link>. Studies described in English were included if the treatment duration was 12 weeks or more, information about ethnicity and baseline HbA1c values were available and a GLP‐1 analogue was compared with a placebo. For the ethnic comparison, we divided the studies into Asian‐dominant studies (≥50% Asian participants) and non‐Asian‐dominant studies (<50% Asian participants).</p> </sec> <sec id="dom12293-sec-0003" sec-type="section"> <title>Results</title> <p id="dom12293-para-0003">Among the 837 searched studies, 15 trials were included for the meta‐analysis. The weighted mean difference of HbA1c with GLP‐1 analogues was −1.16% [95% confidence interval (CI) −1.48, −0.85] in the Asian‐dominant studies and −0.83% (95% CI −0.97, −0.70) in the non‐Asian‐dominant studies. The between‐group difference was −0.32% (95% CI −0.64, −0.01; p = 0.04). The relative risk (RR) with 95% CIs for achieving the target HbA1c ≤7.0% tended to be greater in the Asian‐dominant studies [RR 5.7 (3.8, 8.7)] than in the non‐Asian‐dominant studies [RR 2.8 (2.4, 3.3)]. Body weight changes were similar between the two groups. Hypoglycaemia tended to be more common in Asian‐dominant studies (RR 2.8 [2.3, 3.5]) than in non‐Asian‐dominant studies (RR 1.5 [1.2, 1.8]), but severe hypoglycaemia was very rare in both groups.</p> </sec> <sec id="dom12293-sec-0004" sec-type="section"> <title>Conclusion</title> <p id="dom12293-para-0004">GLP‐1 analogues lower HbA1c more in Asian‐dominant studies than in non‐Asian‐dominant studies. Further studies are warranted to explore the potential mechanisms of the ethnic difference.</p> </sec> </abstract>