Saxagliptin and sitagliptin in adult patients with type 2 diabetes: a systematic review and meta-analysis
Diabetes, Obesity and Metabolism,  Evidence Based Medicine  Clinical Article

Gerrald KR et al. – Sitagliptin and saxagliptin result in similar modest HbA1c reductions and do not increase the risk of hypoglycaemia unless combined with other therapies. Their role in the long–term treatment of type 2 diabetes remains unclear given the lack of long–term data on efficacy, harms and health outcomes.

Methods
  • The authors searched MEDLINE, Embase, the Cochrane Library and the International Pharmaceuticals from their inception through 3 February 2011.
  • Studies were included of adults with type 2 diabetes that were 12 weeks or more in duration.
  • Meta-analyses were conducted when included studies were homogenous enough to justify combining their results.

Results
  • A total of 32 articles met inclusion criteria.
  • Sitagliptin 100 mg monotherapy and saxagliptin 5 mg resulted in greater HbA1c reduction compared to placebo [weighted mean difference (WMD) -0.82%, 95% CI -0.95 to -0.70 and WMD -0.70, 95% CI -0.84 to -0.56, respectively].
  • Sitagliptin was similar to sulfonylureas for HbA1c reduction (WMD 0.08%, 95% CI 0-0.16, 3 trials) and to saxagliptin in one head-to-head trial.
  • There was no statistically significant difference in hypoglycaemia between sitagliptin (pooled RR 1.55, 95% CI 0.55-4.36) or saxagliptin (pooled RR 1.04, 95% CI 0.28-3.81) and placebo.

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