Mei Zhan1, Ting Xu, Fengbo Wu, Yao Tang. 1. Department of Pharmacy, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China.
Abstract
OBJECTIVE: To evaluate the benefits and harms of sitagliptin in people with type 2 diabetes mellitus. METHODS: Randomized controlled trials (RCTs) were retrieved from PubMed, Embase, and the Cochrane central register of controlled trials (Cochrane Library). We used the method recommend by the Cochrane Collaboration to perform a meta-analysis of RCTs of sitagliptin therapy for type 2 diabetes. RESULTS: Of 817 studies retrieved in the literature search, 18 were eligible for inclusion. When sitagliptin was compared with placebo there was a statistically significant reduction in haemoglobin A1C (HbA1c) (MD = 0.74, 95% CI 0.63 to 0.85) and fasting plasma glucose (FPG) (MD = 1.20, 95% CI 1.03 to 1.38). Sitagliptin significantly improved the homeostasis model assessment of β-cell (HOMA-β index) (MD =-10.84, 95% CI -14.07 to -7.80) versus placebo. In participants treated with placebo, hypoglycemia adverse experiences (RR = 2.11, 95% CI 1.50 to 2.36) and serious adverse experiences (RR = 1.20, 95% CI 0.89 to 1.63) were less common. Meta-analysis did not show a significant difference in change in FPG (MD =-0.32, 95% CI -0.76 to 0.13) or HOMA-β index (MD = 4.42, 95% CI -1.22 to 10.07) between the sitagliptin and active control groups, but active treatments provided modestly greater reduction in HbA1c (MD =-0.20, 95% CI -0.37 to -0.03) compared with sitagliptin. No significant difference was observed between the sitagliptin and active treatments in incidence of hypoglycemia adverse experiences (RR = 0.38, 95% CI 0.14 to 1.08) or serious adverse experiences (RR = 1.15, 95% CI 0.83 to 1.65). CONCLUSIONS: Sitagliptin treatment for type 2 diabetes was effective and well tolerated. Sitagliptin offers a novel therapeutic approach for the treatment of type 2 diabetes. Continued assessment in longer term studies is required to determine the role of sitagliptin in type 2 diabetes.
OBJECTIVE: To evaluate the benefits and harms of sitagliptin in people with type 2 diabetes mellitus. METHODS: Randomized controlled trials (RCTs) were retrieved from PubMed, Embase, and the Cochrane central register of controlled trials (Cochrane Library). We used the method recommend by the Cochrane Collaboration to perform a meta-analysis of RCTs of sitagliptin therapy for type 2 diabetes. RESULTS: Of 817 studies retrieved in the literature search, 18 were eligible for inclusion. When sitagliptin was compared with placebo there was a statistically significant reduction in haemoglobin A1C (HbA1c) (MD = 0.74, 95% CI 0.63 to 0.85) and fasting plasma glucose (FPG) (MD = 1.20, 95% CI 1.03 to 1.38). Sitagliptin significantly improved the homeostasis model assessment of β-cell (HOMA-β index) (MD =-10.84, 95% CI -14.07 to -7.80) versus placebo. In participants treated with placebo, hypoglycemia adverse experiences (RR = 2.11, 95% CI 1.50 to 2.36) and serious adverse experiences (RR = 1.20, 95% CI 0.89 to 1.63) were less common. Meta-analysis did not show a significant difference in change in FPG (MD =-0.32, 95% CI -0.76 to 0.13) or HOMA-β index (MD = 4.42, 95% CI -1.22 to 10.07) between the sitagliptin and active control groups, but active treatments provided modestly greater reduction in HbA1c (MD =-0.20, 95% CI -0.37 to -0.03) compared with sitagliptin. No significant difference was observed between the sitagliptin and active treatments in incidence of hypoglycemia adverse experiences (RR = 0.38, 95% CI 0.14 to 1.08) or serious adverse experiences (RR = 1.15, 95% CI 0.83 to 1.65). CONCLUSIONS:Sitagliptin treatment for type 2 diabetes was effective and well tolerated. Sitagliptin offers a novel therapeutic approach for the treatment of type 2 diabetes. Continued assessment in longer term studies is required to determine the role of sitagliptin in type 2 diabetes.