The efficacy and safety of DPP4 inhibitors compared to sulfonylureas as add-on therapy to metformin in patients with Type 2 diabetes: A systematic review and meta-analysis

摘要: There is no consensus on the selection of specific drug therapies when metformin fails in Type 2 diabetes (T2D). This meta-analysis was performed to determine efficacy and safety Dipeptidyl peptidase-4 inhibitors (DPP4-I) compared sulfonylurea (SU) as add-on therapy inadequately controlled T2D patients. We searched MEDLINE, CENTRAL, EMBASE, CINAHL for randomized trials comparing DPP4-I SU reported a change hemoglobin A1c (HbA1c). Sixteen articles were included. significantly greater reduction HbA1c from baseline 12 weeks with versus (MD[95% CI]=0.21%(2 mmol/mol) [0.06, 0.35]) but significant difference at 52 104 CI]=0.06%(-1 [-0.03, 0.15] 0.02%(-1 [-0.13,0.18] respectively). associated weight gain loss all time-points. The incidence hypoglycemia 12, 52, (20%, 24%, 27% respectively) (6%, 3%, 4% proportion patients HbA1c<7%(53 without higher among (RR[95% CI]=1.20 [1.05, 1.37] 1.53 [1.16, 2.02] between two groups other side effects. While both can be considered options T2D, results increased risk gain. By contrast, produce 0.4-0.6% (4-7 HbA1c, lower hypoglycemia, loss.