Saxagliptin and sitagliptin in adult patients with type 2 diabetes: a systematic review and meta-analysis
Diabetes, Obesity and Metabolism, 05/09/2012
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.
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.
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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