Academic Journal
Efficacy and safety of DPP-4 inhibitors in patients with type 2 diabetes: Meta-analysis of placebo-controlled randomized clinical trials
| العنوان: | Efficacy and safety of DPP-4 inhibitors in patients with type 2 diabetes: Meta-analysis of placebo-controlled randomized clinical trials |
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| المؤلفون: | Rehman, M., Tudrej, B.V., Soustre, J., Buisson, M., Archambault, P., Pouchain, D., Vaillant-Roussel, H., Gueyffier, François, Faillie, J.-L., Perault-Pochat, M.C., Cornu, C., Boussageon, R. |
| المساهمون: | Service de cardiologie CHU de Poitiers, Centre hospitalier universitaire de Poitiers = Poitiers University Hospital (CHU de Poitiers La Milétrie ), Université de Poitiers - UFR Santé Faculté de Médecine et de Pharmacie, Université de Poitiers = University of Poitiers (UP), CIC 1407, Hospices Civils de Lyon (HCL), Université de Tours (UT), Université Clermont Auvergne 2017-2020 (UCA 2017-2020 ), Centre d'Investigation Clinique CHU Clermont-Ferrand (CIC 1405), Institut National de la Santé et de la Recherche Médicale (INSERM)-Direction de la Recherche Clinique et de l’Innovation CHU Clermont-Ferrand (DRCI), CHU Clermont-Ferrand-CHU Clermont-Ferrand, CHU Clermont-Ferrand, Evaluation et modélisation des effets thérapeutiques LBBE, Département biostatistiques et modélisation pour la santé et l'environnement LBBE, Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), CIC Poitiers – Centre d'investigation clinique de Poitiers (CIC 1402), Université de Poitiers = University of Poitiers (UP)-Centre hospitalier universitaire de Poitiers = Poitiers University Hospital (CHU de Poitiers La Milétrie )-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| المصدر: | ISSN: 1262-3636. |
| بيانات النشر: | HAL CCSD Elsevier Masson |
| سنة النشر: | 2017 |
| المجموعة: | Université François-Rabelais de Tours: HAL |
| مصطلحات موضوعية: | Type 2 diabetes, DPP-4 inhibitors, Meta-analysis, Micro- and macrovascular complications, Mortality, Randomized clinical trials, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism |
| الوصف: | International audience ; BACKGROUND:Guidelines for type 2 diabetes (T2D) recommend reducing HbA1c through lifestyle interventions and glucose-lowering drugs (metformin, then combination with dipeptidyl peptidase-4 inhibitors [DPP-4Is] among other glucose-lowering drugs). However, no double-blind randomized clinical trial (RCT) compared with placebo has so far demonstrated that DDP-4Is reduce micro- and macrovascular complications in T2D. Moreover, the safety of DPP-4Is (with increased heart failure and acute pancreatitis) remains controversial.METHODS:A systematic review of the literature (PubMed, Cochrane Library Central Register of Controlled Trials [CENTRAL] and https://clinicaltrials.gov), including all RCTs vs placebo published up to May 2015 and the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS), published June 2015, was performed. Primary endpoints were all-cause mortality and death from cardiovascular causes; secondary endpoints were macrovascular and microvascular events. Safety endpoints were acute pancreatitis, pancreatic cancer, serious adverse events and severe hypoglycaemia.RESULTS:A total of 36 double-blind RCTs were included, allowing analyses of 54,664 patients. There were no significant differences in all-cause mortality (RR=1.03, 95% confidence interval [CI]=0.95-1.12), cardiovascular mortality (RR=1.02, 95% CI=0.92-1.12), myocardial infarction (RR=0.98, 95% CI=0.89-1.08), strokes (RR=1.02, 95% CI=0.88-1.17), renal failure (RR=1.06, 95% CI=0.88-1.27), severe hypoglycaemia (RR=1.14, 95% CI=0.95-1.36) and pancreatic cancer (RR=0.54, 95% CI=0.28-1.04) with the use of DPP-4Is. However, DDP-4Is were associated with an increased risk of heart failure (RR=1.13, 95% CI=1.01-1.26) and of acute pancreatitis (RR=1.57, 95% CI=1.03-2.39).CONCLUSION:There is no significant evidence of short-term efficacy of DPP-4Is on either morbidity/mortality or macro-/microvascular complications in T2D. However, there are warning signs concerning heart failure and acute pancreatitis. This suggests a ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/27745828; PUBMED: 27745828 |
| DOI: | 10.1016/j.diabet.2016.09.005 |
| الاتاحة: | https://hal.science/hal-01808205 https://doi.org/10.1016/j.diabet.2016.09.005 |
| رقم الانضمام: | edsbas.D4DF66F8 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.diabet.2016.09.005 |
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