Efficacy And Safety Of Combination Therapy With Linagliptin And Metformin In Patients With Type 2 Diabetes:A Meta-analysis

Objective:AIM To evaluate the efficacy and safety of combination therapy with linagliptin and metformin in patients with type 2 diabetes mellitus(T2DM).Methods:All randomized controlled trials (RCTs) of linagliptin therapy in patients with type 2 diabetes were retrieved from the CNKI, Wanfang, VIP, Pubmed, ISI Web of Science and EMBase. Meta-analysis was performed using RevMan 5.1 software. Linagliptin combine metformin (experimental group) and placebo combine or metformin alone (control group) treatment on patients with T2DM glycosylated hemoglobin (HbAlc) and fasting plasma glucose (FPG) levels and the incidence of hypoglycemia were compared.Results:A total of 725 English and Chinese literatures were detected. Four RCTs including 2 036 patients were ultimately analyzed. In reducing HbAlc levels, the experimental group (linagliptin 2.5 mg, bid) was better than control group [standardized mean difference (SMD)=7.47,95% confidence interval (CI):10.37-4.58, P<0.001), while the experimental group (linagliptin 5 mg, bid) compared with the control group had no significant meaning (SMD= 9.13,95% CI:18.86-0.60, P<0.001). Reduce FPG levels in the experimental group was significantly better than the control group (SMD=-6.00, 95% CI:-8.82--3.91, P<0.001). The incidence of hypoglycemia in the experimental group (linagliptin 2.5mg, bid) was no significant differences in the control group (relative risk (RR)=0.94,95% CI:0.16-5.50, P=0.94), while that in the experimental group (linagliptin 5 mg, qd) was significantly decreased (RR=0.24,95% CI:0.07-0.80, P= 0.02).Conclusion:Linagliptin combine metformin therapy can effectively reduce HbA1c and FPG levels in patients with type 2 diabetes, and with better security. But on account of high heterogeneity of this research, the aforesaid conclusion need to be confirmed further.