| Title | Efficacy and Acceptability of Glycemic Control of Glucagon-Like Peptide-1 Receptor Agonists among Type 2 Diabetes: A Systematic Review and Network Meta-Analysis |
| Authors | Li, Zhixia Zhang, Yuan Quan, Xiaochi Yang, Zhirong Zeng, Xiantao Ji, Linong Sun, Feng Zhan, Siyan |
| Affiliation | Peking Univ, Hlth Sci Ctr, Sch Publ Hlth, Dept Epidemiol & Biostat, Beijing 100871, Peoples R China. McMaster Univ, Dept Clin Epidemiol & Biostat, 1280 Main St West, Hamilton, ON, Canada. Wuhan Univ, Zhongnan Hosp, Ctr Evidence Based & Translat Med, Wuhan 430072, Peoples R China. Peking Univ, Peoples Hosp, Dept Endocrinol & Metab, Beijing 100871, Peoples R China. |
| Keywords | RANDOMIZED CONTROLLED-TRIAL PLACEBO-CONTROLLED TRIAL TWICE-DAILY EXENATIDE BETA-CELL FUNCTION ONCE-DAILY LIXISENATIDE HUMAN GLP-1 ANALOG METFORMIN-TREATED PATIENTS BIPHASIC INSULIN ASPART DRUG-NAIVE PATIENTS DOUBLE-BLIND |
| Issue Date | 2016 |
| Publisher | PLOS ONE |
| Citation | PLOS ONE.2016,11,(5). |
| Abstract | Objective To synthesize current evidence of the impact of Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on hypoglycemia, treatment discontinuation and glycemic level in patients with type 2 diabetes. Design Systematic review and network meta-analysis. Data Sources Literature search (Medline, Embase, the Cochrane library), website of clinical trial, bibliographies of published systematic reviews. Eligibility Criteria Randomized controlled trials with available data comparing GLP-1 RAs with placebo or traditional anti-diabetic drugs in patients with type 2 diabetes. Data Synthesis Traditional pairwise meta-analyses within DerSimonian-Laird random effects model and network meta-analysis within a Bayesian framework were performed to calculate odds ratios for the incidence of hypoglycemia, treatment discontinuation, HbA1c < 7.0% and HbA1c < 6.5%. Ranking probabilities for all treatments were estimated to obtain a treatment hierarchy using the surface under the cumulative ranking curve (SUCRA) and mean ranks. Results 78 trials with 13 treatments were included. Overall, all GLP-1 RAs except for albiglutide increased the risk of hypoglycemia when compared to placebo. Reduction in the incidence of hypoglycemia was found for all GLP-1 RAs versus insulin (except for dulaglutide) and sulphonylureas. For the incidence of treatment discontinuation, increase was found for exenatide, liraglutide, lixisenatide and taspoglutide versus placebo, insulin and sitagliptin. For glycemic level, decrease was found for all GLP-1 RAs versus placebo. Dulaglutide, exenatide long-acting release (exe_lar), liraglutide and taspoglutide had significant lowering effect when compared with sitagliptin (HbA1c < 7.0%) and insulin (HbA1c < 6.5%). Finally, according to SUCRAs, placebo, thiazolidinediones and albiglutide had the best decrease effect on hypoglycemia; sulphanylureas, sitagliptin and insulin decrease the incidence of treatment discontinuation most; exe_lar and dulaglutide had the highest impact on glycemic level among 13 treatments. Conclusions Among 13 treatments, GLP-1 RAs had a significant reduction with glycemic level but a slight increase effect on hypoglycemia and treatment discontinuation. While albiglutide had the best decrease effect on hypoglycemia and treatment discontinuation among all GLP-1 RAs. However, further evidence is necessary for more conclusive inferences on mechanisms underlying the rise in hypoglycemia. |
| URI | http://hdl.handle.net/20.500.11897/433810 |
| ISSN | 1932-6203 |
| DOI | 10.1371/journal.pone.0154206 |
| Indexed | SCI(E) PubMed |
| Appears in Collections: | 公共卫生学院 人民医院 |
