Efficacy and safety of sodium‐glucose cotransporter‐2 inhibitors versus dipeptidyl peptidase‐4 inhibitors as monotherapy or add‐on to metformin in patients with type 2 diabetes mellitus: A systematic review and meta‐analysis. Issue 1 (10th August 2017)

• Record Type: Journal Article
• Authors: Wang, Zhiying; Sun, Jiahui; Han, Ruobing; Fan, Dongzhu; Dong, Xinyi; Luan, Zenghui; Xiang, Rongwu; Zhao, Mingyi; Yang, Jingyu
• Is Part Of: Diabetes, obesity & metabolism. Volume 20:Issue 1(2018)
• Page Start: 113
• Page End: 120
• Publication Date: 2017-08-10
• Subjects: dipeptidyl peptidase‐4 inhibitors -- sodium‐glucose cotransporter‐2 inhibitors -- type 2 diabetes mellitus; Diabetes -- Periodicals; Obesity -- Periodicals; Metabolism -- Disorders -- Periodicals; Clinical pharmacology -- Periodicals; 616.462
• DOI: 10.1111/dom.13047
• Languages: English
• ISSNs: 1462-8902

Abstract

Abstract : Aims: To compare the efficacy and safety of dipeptidyl peptidase‐4 inhibitors (DPP‐4is) and sodium‐glucose cotransporter‐2 inhibitors (SGLT‐2is) as monotherapy or add‐on to metformin (Met) in patients with type 2 diabetes mellitus (T2DM). Materials and Methods: PubMed, Embase andClinicalTrials.gov sites were systematically searched for randomized controlled trials to assess the efficacy and safety of DPP‐4is and SGLT‐2is in patients with T2DM. Risk ratio (RR) and weighted mean difference (WMD) were used to evaluate outcomes. Results: In the analysis of 25 randomized trials, which involved 14 619 patients, SGLT‐2is were associated with a significantly stronger reduction in haemoglobin A1c (HbA1c) (WMD 0.13%, 95% credible interval [CI], 0.04%‐0.22%, P = .005) and fasting plasma glucose (FPG) (WMD 0.80 mmol/L, 95% CI, 0.58‐1.01 mmol/L, P < .00001) than were DPP‐4is. However, no significant difference between the 2 drug categories was found in the risk of hypoglycaemic events (RR, 0.99; 95% CI, 0.78‐1.26, P = .92). SGLT‐2is plus Met was associated with a more significant decrease in FPG (WMD 0.71 mmol/L, 95% CI, 0.43‐1.00 mmol/L, P < .00001) than was DPP‐4is plus Met. However, no differences were found in the reduction of HbA1c (WMD 0.11%, 95% CI, −0.03%‐0.25%, P = .12) or the risk of hypoglycaemic events (RR, 1.02; 95% CI, 0.80‐1.31, P = .86). Conclusions: This review revealed that, compared to DPP‐4is, SGLT‐2is significantly reduced HbA1c, FPG and body weight without increasing the risk of hypoglycaemia in diabetes treatment.