Efficacy And Safety Of DPP-4 Inhibitors And The Others Hypoglycemic Agents Based On Metformin:A Meta-analysis

Aim In order to compare the efficacy and safety of DPP-4 inhibitors with other hypoglycemic agents when combined with metformin in patients with type 2 diabetes.Methods English databases:(Pubmed,Embase,Cochrane Library)and Chinese databases:(CNKI,Wan Fang,VIP,CBM)were searched with computer by the end of June 1 2015.We filtered and evaluated literatures based on the inclusion and exclusion criteria.The meta-analysis was conducted with Rev-Man 5.3.5.Results 1.DPP-4 inhibitors + metformin vs.sulfonylureas(SUs)+ metformin The reduction of Hb A1 c was comparable between the two groups;In FPG,SUs + metformin could provide greater reduction compared with DPP-4 inhibitors + metformin with statistically significant difference;In the incidence of total adverse events(AEs),hypoglycema and the reduction of body weight,DPP-4 inhibitors + meformin was superior to SUs + metformin with with statistically significant difference.2.DPP-4 inhibitors + metformin vs.thiazolidinedions(TZDs)+ metformin The incidence of total AEs,hypoglycema and the reduction of Hb A1 c,FPG were comparable between the two groups;In FPG,SUs + metformin could provide greater reduction compared with DPP-4 inhibitors + metformin with statistically significant difference;In body weight,DPP-4 inhibitors + metformin could provide greater reduction compared with SUs + metformin with statistically significant difference.3.DPP-4 inhibitors + metformin vs.GLP-1 receptor agonist + metformin In the reduction of Hb A1 c,FPG and body weight,GLP-1 receptor agonist + metformin was superior to DPP-4 inhibitors + metformin with statistically significant difference;In total AEs,DPP-4 inhibitors + metformin could provide lower incidence compared with GLP-1 receptor agonist + metformin with statistically significant difference.The incidence of hypoglycema was comparable between the two groups.4.DPP-4 inhibitors + metformin vs.SGLT-2 inhibitors + metformin In the reduction of FPG and body weight,SGLT-2 inhibitors + metformin was superior to DPP-4 inhibitors + metformin with statistically significant difference;The reduction of Hb A1 c and the the incidence of total AEs and hypoglycema were comparable between the two groups.Results The efficacy of DPP-4 inhibitors + metformin in controlling blood glucose was only inferior to GLP-1 receptor agonist(P<0.05),and was comparable with the others combinations(P>0.05).DPP-4 inhibitors could reduce weight slightly.In addition,the safety of DPP-4 inhibitors + metformin was satisfactory,the incidence of total AEs and hypoglycema was low.So DPP-4 inhibitors+metformin could be regarded as a effective therapy in the treatment of type 2 diabetes.