[1]孔文强,文露,张春燕,等.卡格列净、恩格列净、达格列净治疗T2DM患者安全性的网状Meta分析[J].第三军医大学学报,2018,40(19):1792-1804.
 KONG Wenqiang,WEN Lu,ZHANG Chunyan,et al.Safety of canagliflozin, empagliflozin and dapagliflozin for T2DM patients: a network meta-analysis[J].J Third Mil Med Univ,2018,40(19):1792-1804.
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
40卷
期数:
2018年第19期
页码:
1792-1804
栏目:
临床医学
出版日期:
2018-10-15

文章信息/Info

Title:
Safety of canagliflozin, empagliflozin and dapagliflozin for T2DM patients: a network meta-analysis
作者:
孔文强文露张春燕杜彪
西南医科大学药学院;四川省人民医院药学部;川北医学院药学院;重庆三峡中心医院药学部
Author(s):
KONG Wenqiang WEN Lu ZHANG Chunyan DU Bia

School of Pharmacy, Southwest Medical University,  Luzhou, Sichuan Province, 646000; Department of Pharmacy, Sichuan Provincial People’s Hospital, Chengdu, Sichuan Province, 610072; School of Pharmacy, North Sichuan Medical Collage, Nanchong, Sichuan Province, 637000; Department of Pharmacy, Chongqing Three Gorges Central Hospital, Wanzhou, Chongqing, 404000, China
 

关键词:
SGLT22型糖尿病安全性网状Meta分析  
Keywords:
SGLIT2 type 2 diabetes mellitus safety network meta-analysis  
分类号:
R587.1; R589.1
文献标志码:
A
摘要:

目的     采用Meta分析研究评价卡格列净、恩格列净、达格列净治疗2型糖尿病患者的安全性。方法     检索PubMed、CENTRAL、Embase数据库,检索时限从建库到2018年1月,纳入有关RCT文献,传统Meta分析和网状Meta分析用STATA14完成。结果    共纳入34篇文献,含21 216名患者的35项RCT。Meta分析结果显示,卡格列净、恩格列净、达格列净与安慰剂和阳性药物相比:①均不会增加因不良反应退出人数,差异无统计学意义(P>0.05);②能够显著增加生殖器感染的人数,且女性感染人数要明显多于男性,差异均有统计学意义(P<0.05);③仅达格列净可轻微增加尿路感染人数[OR=1.26,95%CI(1.02~1.55),P=0.039]。④卡格列净与恩格列净[OR=1.53,95%CI(1.02~2.30)P<0.05]、安慰剂[OR=1.74,95%CI(1.32~2.30)P<0.05]相比,明显增加了低血糖发生人数。⑤恩格列净和达格列净与DPP4抑制剂、GLP1激动剂、二甲双胍、安慰剂相比,低血糖发生人数差异无统计学意义(P>0.05)。结论    卡格列净、恩格列净、达格列净治疗2型糖尿病,仅增加生殖器感染人数,有较好的耐受性和安全性;3种药物中恩格列净耐受性和安全性可能最好。

Abstract:

ObjectiveTo evaluate the safety of canagliflozin, empagliflozin and dapagliflozin in treatment of type 2 diabetes mellitus (T2DM) by network meta-analysis. MethodsThe databases including PubMed, Embase,and CENTRAL from inception to January 2018 were searched for eligible randomized controlled trials (RCTs) evaluating the SGLT2 inhibitors in T2DM patients. Conventional meta-analysis and network metaanalysis were performed by STATA14. ResultsA total of 34 studies, including 35 RCTs, involving 21 216 patients were collected. Meta-analysis showed that when compared with placebo and positive agents: ① the 3 drugs didn’t increase the number of patients who required discontinuation due to adverse events (P>0.05); ② they significantly increased the number of genital infections, especially in women, with significant differences (P<0.05). ③ Only dapagliflozin slightly raised the number of urinary tract infections (UTIs) (OR=1.26, 95%CI: 1.02~1.55, P=0.039); ④ Compared with empagliflozin (OR=1.53, 95%CI: 1.02~2.30, P<0.05) and placebo (OR=1.74, 95%CI: 1.32~2.30, P<0.05), canagliflozin slightly increased the incidence of hypoglycemia; ⑤ Empagliflozin and dapagliflozin didn’t increase the incidence of hypoglycemia,when compared with DPP-4 inhibitors, GLP-1 agonists, metformin and placebo (P>0.05). ConclusionCanagliflozin, empagliflozin and dapagliflozin show better tolerance and safety, though increasing the risk of genital infections in treatment of T2DM. Among them, empagliflozin may be the best in tolerance and durability.

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更新日期/Last Update: 2018-10-17