Journal
NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
Volume 20, Issue 4, Pages 224-235Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.numecd.2009.03.015
Keywords
Type 2 diabetes mellitus; Dipeptidyl Peptidase-4 inhibitors; Meta-analysis
Funding
- Abiogen Pharma
- Glaxo-Smith-Kline
- Guidotti
- Eli Lilly
- Menarini
- Merck Sharp Et Dome (manufacturer of sitagliptin)
- Merck KgA
- Novo Nordisk
- Novartis (manufacturer of vildagliptin)
- Sanofi Aventis
- Takeda
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Background and Aim: The role of Dipeptidyl Peptidase-4 (DPP-4) inhibitors in the treatment of type 2 diabetes is debated; many recent trials, which were not included in previous meta-analyses, could add relevant information. Methods and Results: All available randomized controlled trials (RCTs), either published or unpublished, performed in type 2 diabetic patients with DPP-4 inhibitors, with a duration >12 weeks were meta-analyzed for HbA1c, BMI, hypoglycemia, and other adverse events. A total of 41 RCTs (9 of which are unpublished) was retrieved and included in the analysis. Gliptins determine a significant improvement of HbA1c in comparison with a placebo (-0.7 [-0.8:-0.6]), with a low risk of hypoglycemia. DPP-4 inhibitors show a similar efficacy in monotherapy and in combination with other agents. The risk of cardiovascular events and all-cause death with DPP-4 inhibitors is 0.76 [0.46-1.28] and 0.78 [0.40-1.51], respectively. Conclusions: DPP-4 inhibitors reduce HbA1c, although to a lesser extent than sulphonylureas, with no weight gain and no hypoglycemic risk; further data are needed to assess their long-term safety. (C) 2009 Elsevier B.V. All rights reserved.
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