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Incretin‐based medications for type 2 diabetes: an overview of reviews
Author(s) -
Gamble J.M.,
Clarke A.,
Myers K. J.,
Agnew M. D.,
Hatch K.,
Snow M. M.,
Davis E. M.
Publication year - 2015
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12465
Subject(s) - medicine , systematic review , checklist , cochrane library , observational study , medline , randomized controlled trial , incretin , type 2 diabetes , diabetes mellitus , psychology , endocrinology , political science , law , cognitive psychology
Aims To summarize evidence from and assess the quality of published systematic reviews evaluating the safety, efficacy and effectiveness of incretin‐based medications used in the treatment of type 2 diabetes. Methods We identified systematic reviews of randomized controlled trials or observational studies published in any language that evaluated the safety and/or effectiveness of glucagon‐like peptide‐1 ( GLP ‐1) receptor agonists or dipeptidyl‐peptidase‐4 ( DPP ‐4) inhibitors. Data sources used include the C ochrane L ibrary, PubMed , EMBASE , W eb of S cience, I nternational P harmaceutical A bstracts, table of contents of diabetes journals, and hand‐searching of reference lists and clinical practice guidelines. The methodological quality of systematic reviews was independently assessed by two reviewers using the A ssessment of M ultiple S ystematic R eviews ( AMSTAR ) checklist. Our study protocol was registered with PROSPERO (2013: CRD42013005149 ). The primary outcomes were pooled treatment effect estimates for glycaemic control, macrovascular and microvascular complications, and hypoglycaemic events. Results We identified 467 unique citations of which 84 systematic reviews met our inclusion criteria. There were 51 reviews that evaluated GLP ‐1 receptor agonists and 64 reviews that evaluated DPP ‐4 inhibitors. The median (interquartile range) AMSTAR score was 6 (3) out of 11 for quantitative and 1 (1) for non‐quantitative reviews. Among the 66 quantitative systematic reviews, there were a total of 718 pooled treatment effect estimates reported for our primary outcomes and 1012 reported pooled treatment effect estimates for secondary outcomes. Conclusions Clinicians and policy makers, when using the results of systematic reviews to inform decision‐making with regard to round clinical care or healthcare policies for incretin‐based medications, should consider the variability in quality of reviews.