DPP-4 inhibitors and risk of infections: a meta-analysis of randomized controlled trials

BackgroundTo evaluate the risk of infections in the treatment of type 2 diabetes patients with dipeptidyl-peptidase 4 (DPP-4) inhibitors. MethodsA literature search was conducted through electronic databases. The inclusion criteria included study duration of no less than 12weeks developed in type 2 diabetes patients, the use of a randomized control group receiving a DPP-4 inhibitor and the availability of outcome data for infections. Out of 2181 studies, 74 studies were finally included. ResultsThe risk of overall infection for DPP-4 inhibitors treatment was comparable to placebo (odds ratio (OR)=0.97, 95% confidence interval (CI), 0.91 to 1.04, p=0.40), metformin treatment (OR=1.22, 95% CI, 0.95 to 1.56, p=0.12), sulphonylurea treatment (OR=1.09, 0.93 to 1.29, p=0.29), thiazolidinedione treatment (OR=0.86, 95% CI, 0.65 to 1.14, p=0.29) and alpha glucosidase inhibitor treatment (OR=1.03, 95% CI, 0.33 to 3.22, p=0.96). When compared different DPP-4 inhibitors with placebo treatment, risks of infections were comparable for alogliptin, linagliptin, sitagliptin, saxagliptin and vildagliptin. Compared with placebo or active comparator treatment, risks of infection in different systems for DPP-4 inhibitors were all comparable. ConclusionsThe overall risk of infections of DPP-4 inhibitor was not increased compared with control groups. Copyright (c) 2015 John Wiley & Sons, Ltd.