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Sitagliptin in the treatment of type 2 diabetes: a meta‐analysis
Author(s) -
Zhan Mei,
Xu Ting,
Wu Fengbo,
Tang Yao
Publication year - 2012
Publication title -
journal of evidence‐based medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.885
H-Index - 22
ISSN - 1756-5391
DOI - 10.1111/j.1756-5391.2012.01189.x
Subject(s) - sitagliptin , medicine , sitagliptin phosphate , placebo , hypoglycemia , meta analysis , adverse effect , cochrane library , diabetes mellitus , type 2 diabetes , randomized controlled trial , gastroenterology , endocrinology , pathology , alternative medicine
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 (HbA 1c ) (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 HbA 1c (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.