Abstract��OBJECTIVE To systematically review the efficacy and safety of dipeptidyl peptidase-4(DPP-4) inhibitors versus glucagon like peptide-1(GLP-1) receptor agonists for type 2 diabetes mellitus(T2DM). METHODS Databases including EMbase,PubMed, The Cochrane Library, Clinical Trial, CBM,CNKI and WanFang Data, were searched electronically for randomized controlled trials (RCTs) of DPP-4 inhibitors versus GLP-1 receptor agonists for T2DM up to December 2015. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then Meta-analysis was performed using RevMan 5.3 soft ware. RESULTS A total of 13 RCTs were included. The RESULTS of Meta-analysis showed that compared with DPP-4 inhibitors, GLP-1 receptor agonists were more effective in reducing the levels of fasting plasma glucose [MD=0.93, 95%CI(0.48,1.38), P��0.000 1] and glycated hemoglobin [MD=0.53,95%CI(0.34,0.73), P��0.000 01] and BMI [MD=1.53,95%CI(0.83,2.22),P��0.001]. However, DPP-4 inhibitors were more effective than GLP-1 receptor agonists in the reducing the 2-hour postprandial blood glucose level. And GLP-1 receptor agonists were more prone to cause gastrointestinal adverse reactions than DPP-4 inhibitors [RR=0.44,95% CI (0.33, 0.59), P<0.000 1]. CONCLUSION GLP-1 receptor agonists are superior to DPP-4 inhibitors in controlling the fasting plasma glucose and glycated hemoglobin levels and reducing the body weight of T2DM patients, while DPP-4 inhibitors have better efficacy in reducing 2-hour postprandial blood glucose level, with better tolerability.
л�, ����ΰ, ������, ��ӽ÷. DPP-4���Ƽ���GLP-1���弤�����Ƚ�����2��������Ч�ԺͰ�ȫ�Ե�Meta����[J]. �й�ҩѧ��־, 2016, 51(18): 1600-1607.
XIE Jing, JI Li-wei, ZHU Xiao-hong, WANG Yong-mei. Comparison of the Efficacy and Safety between DPP-4 Inhibitors and GLP-1 Analogues for Treatment of Type 2 Diabetes Mellitus: A Meta-analysis. Chinese Pharmaceutical Journal, 2016, 51(18): 1600-1607.
LING X M, YANG C X. Effect of saxagliptin on the ��-cell function of patients with type 2 diabetes: a systematic review[J]. Chin J Evid-based Med, 2013, 13(4): 436-440.
[2]
CHEN X, ZHAI S D. Review of the comparison between GLP-1 analogues and DPP-4 inhibitors [J]. Drug Evaluation, 2013, 10(11):20-23.
[3]
ARNOLDS S, DELLWEG S, CLAIR J, et al. Further improvement in postprandial glucose control with addition of exenatide or sitagliptin to combination therapy with insulin glargine and metformin[J]. Diabetes Care, 2010, 33(7): 1509-1515.
[4]
BERGENSTAL R M, WYSHAM C, MACCONELL L, et al. Efficacy and safety of exenatide once weekly versus sitagliptin or pioglitazone as an adjunct to metformin for treatment of type 2 diabetes (DURATION-2): a randomized trial[J]. Lancet, 2010, 376(9739):431-439.
[5]
CHARBONNEL B, STEINBERG H, EYMARD E, et al. Efficacy and safety over 26 weeks of an oral treatment strategy including sitagliptin compared with an injectable treatment strategy with liraglutide in patients with type 2 diabetes mellitus inadequately controlled on metformin: a randomised clinical trial[J]. Diabetologia, 2013,56(7):1503-1511.
[6]
PRATLEY R E, NAUCK M, BAILEY T, et al. Liraglutide versus sitagliptin for patients with type 2 diabetes who did not haveadequate glycaemic control with metformin: a 26-week, randomised, parallel-group, open-label trial[J]. Lancet, 2010, 375(9724): 1447-1456.
[7]
RUSSELL J D, CUDDIHY R M, HANEFELD M, et al. Efficacy and safety of exenatide once weekly versus metformin, pioglitazone, and sitagliptin used as monotherapy in drug-naive patients with type 2 diabetes (DURATION-4)[J]. Diabetes Care, 2012,35(2): 252-258.
[8]
CHEN B,ZHANG X G,LI Y L,et al. Effect observation of liraglutide and sitagliptin respectively combined with metformin in treatment of patientswith type 2 diabetes mellitus [J]. Med Pharm J Chin PLA(��ž�ҽҩ��־),2014,26(9):44-46,50.
[9]
CHEN R,YU P,LI C,et al. Comparison of efficacy and safety between liraglutide and sitagliptin in overweight and obese type 2 diabetes patients [J]. Chin J Diabetes Mellitus(�л�������־),2014,6(3):157-162.
[10]
FAN X X, LIU X L, LUO W, et al. Efficacy and safety of liraglutide versus saxagliptin in overweight and obese patients with type 2 diabetesmellitus [J]. Chin J Diabetes Mellitus(�л�������־),2015,23(4):320-322.
[11]
FENG S. I liraglutide and sitagliptin comparative study on treatment of new onset obese type 2 diabetes mellitus [J]. Medical Frontier(ҽҩǰ��),2013, 12(34):266-267.
[12]
LIN X F,CHEN Y. Comparative analysis of GLP-1 receptor agonists and DPP-4 inhibitors in the treatment of type 2 diabetes mellitus [J]. Strait Pharm J(��Ͽҩѧ),2015,27(6):150-151.
[13]
XU N,JIN W B. The analysis of clinical effect of DPP-4 inhibitor versus GLP-1 receptor agonist treatment of type 2 diabetes [J]. Chin J Diabetes Mellitus(�л�������־),2014,22(8):731-733.
[14]
ZHANG X X,YANG H,YANG G Y,et al. Efficacy and safety of exenatide versus saxagliptin combined with metformin inpatients with type 2 diabetes mellitus [J]. J Third Mil Med Univ(������ҽ��ѧѧ��),2013,35(14):1531-1534.
[15]
ZHENG Y Q,YU Y B,LI Y J. Analysis of the efficacy and safety of metformin combined respectively between exenatide and Shah Glenn Dean in treatment of type 2 diabetes mellitus [J]. Chin J Clin Ration Drug Use(�ٴ�������ҩ��־),2014,7(9A):123-124.
[16]
ZHOU Y,HE M,YANG M,et al. Effects of GLP-1 receptor agonists versus DPP-4 inhibitors for type 2 diabetes mellitus: a systematic review [J]. Chin J Evid Base Med(�й�ѭ֤ҽѧ��־),2014,14(12):1459-1466.
[17]
CAO X P, YANG C J. Clinical efficacy and adverse reactions of GLP-1 analogues [J]. Clin Med J(�ٴ�ҩ��������־),2013,11(1):45-48.