Glucose-lowering and the risk of MACE with novel antidiabetic therapies: A systematic review and meta-analysis

2022 ◽  
Author(s):  
Beatriz LUCHIARI
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Glucose Lowering

scholarly journals Efficacy of Modern Diabetes Treatments- Dpp-4i, Sglt-2i, Glp-1ra- in White and Asian Patients With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Author(s):  
Sushrima Gan1 ◽  
Adem Y Dawed ◽  
Louise A Donnelly ◽  
ATN Nair ◽  
Colin NA Palmer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Glucose Lowering ◽  
Asian Ethnicity ◽  
Mesh Terms ◽  
Oral Agents ◽  
The Impact

<b><i><u>Background and Purpose:</u></i></b>The pathophysiology of Type 2 diabetes differs markedly by ethnicity. A systematic review and meta-analysis was conducted to assess the impact of ethnicity on the glucose lowering efficacy of the newer oral agents, SGLT-2is, GLP-1RAs and DPP-4is, using evidence from randomized clinical trials (RCTs). <p><b><i><u>Data Sources:</u></i></b>A literature search was conducted in PubMed of all randomized, placebo-controlled trials of DPP-4 inhibitors, SGLT-2 inhibitors and GLP-1RA. The search strategy was developed based on medical subject sub-headings (MeSH) terms and keywords.</p> <p><b><i><u>Study selection :</u></i></b> 64 studies qualified for meta-analysis after full-text review based on pre-defined inclusion and exclusion criteria. RCTs with at least 50 patients in each arm; >70% of population from Asian or White group; duration>=24 weeks; published up to March 2019 were selected for systematic review and meta-analysis.</p> <p><b><i><u>Data extraction:</u></i></b>Data extraction was done for aggregated study-level data , by two independent researchers. Absolute changes in HbA1c (%) from baseline to 24 weeks between the drug and placebo was considered as the primary endpoint of the study.</p> <p><b><i><u>Data synthesis: </u></i></b>Change in HbA1c was evaluated by computing mean differences (MDs) and 95% confidence intervals (CI) between treatment and placebo arms. </p> <p><b><i><u>Limitations: </u></i></b> Study is based on summarized data and could not be separated based on East Asians and South Asians.</p> <p><b><i><u>Conclusion : </u></i></b>The glucose lowering efficacy of SGLT-2i, and to a lesser extent DPP-4i, was greater in studies of predominantly Asian ethnicity compared to studies of predominantly white ethnicity. There was no difference seen by ethnicity for GLP-1RA.</p>

scholarly journals Efficacy of Modern Diabetes Treatments- Dpp-4i, Sglt-2i, Glp-1ra- in White and Asian Patients With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Author(s):  
Sushrima Gan1 ◽  
Adem Y Dawed ◽  
Louise A Donnelly ◽  
ATN Nair ◽  
Colin NA Palmer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Glucose Lowering ◽  
Asian Ethnicity ◽  
Mesh Terms ◽  
Oral Agents ◽  
The Impact

<b><i><u>Background and Purpose:</u></i></b>The pathophysiology of Type 2 diabetes differs markedly by ethnicity. A systematic review and meta-analysis was conducted to assess the impact of ethnicity on the glucose lowering efficacy of the newer oral agents, SGLT-2is, GLP-1RAs and DPP-4is, using evidence from randomized clinical trials (RCTs). <p><b><i><u>Data Sources:</u></i></b>A literature search was conducted in PubMed of all randomized, placebo-controlled trials of DPP-4 inhibitors, SGLT-2 inhibitors and GLP-1RA. The search strategy was developed based on medical subject sub-headings (MeSH) terms and keywords.</p> <p><b><i><u>Study selection :</u></i></b> 64 studies qualified for meta-analysis after full-text review based on pre-defined inclusion and exclusion criteria. RCTs with at least 50 patients in each arm; >70% of population from Asian or White group; duration>=24 weeks; published up to March 2019 were selected for systematic review and meta-analysis.</p> <p><b><i><u>Data extraction:</u></i></b>Data extraction was done for aggregated study-level data , by two independent researchers. Absolute changes in HbA1c (%) from baseline to 24 weeks between the drug and placebo was considered as the primary endpoint of the study.</p> <p><b><i><u>Data synthesis: </u></i></b>Change in HbA1c was evaluated by computing mean differences (MDs) and 95% confidence intervals (CI) between treatment and placebo arms. </p> <p><b><i><u>Limitations: </u></i></b> Study is based on summarized data and could not be separated based on East Asians and South Asians.</p> <p><b><i><u>Conclusion : </u></i></b>The glucose lowering efficacy of SGLT-2i, and to a lesser extent DPP-4i, was greater in studies of predominantly Asian ethnicity compared to studies of predominantly white ethnicity. There was no difference seen by ethnicity for GLP-1RA.</p>

Glucose-lowering and the risk of MACE with novel antidiabetic therapies: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Beatriz Martinelli Luchiari ◽  
Luiz Sergio Fernandes de Carvalho ◽  
Ana Claudia Cavalcante Nogueira ◽  
Riobaldo Marcelo Ribeiro Cintra ◽  
Isabella Bonilha ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Glucose Lowering

scholarly journals Anti-diabetic agents for prevention of type 2 diabetes mellitus in people with pre-diabetes: a systematic review and network meta-analysis protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e029073 ◽  
Author(s):  
Xianzhe Wang ◽  
Jiabin Liu ◽  
Lijin Huang ◽  
Hai Zeng ◽  
Guoxin He ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetes Prevention ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Glucose Lowering ◽  
Increased Risk

IntroductionType 2 diabetes mellitus (T2DM) is a substantial health problem worldwide. Pre-diabetic state is associated with increased risk for the development of diabetes. There are various pharmacological therapies with glucose-lowering activity for diabetes prevention. Of those, most are being compared with placebo instead of active agents. The relative effects and safety of different glucose-lowering drugs still remain uncertain. To address this gap, we will conduct a systematic review and network meta-analysis (NMA) to evaluate comparative efficacy and safety of glucose-lowering agents for T2DM prevention in patients with pre-diabetes.Methods and analysisPubMed, the Cochrane library and Embase will be searched from inception to December 2019 for relevant randomised controlled trials (RCTs) that examined anti-diabetic drugs for diabetes prevention in patients with pre-diabetes. Two reviewers working independently will screen titles, abstracts and full papers. Data extraction will also be completed by two independent authors. The primary outcome will be the incidence of T2DM in patients with pre-diabetes at baseline. Secondary outcomes will include the achievement of normoglycaemia, all-cause mortality, cardiovascular mortality and hypoglycaemic event. Pairwise meta-analysis and NMA will be conducted for each outcome using a frequentist random-effects model. Additionally, subgroup analyses will also be performed. The comparison-adjusted funnel plot will be used to assess publication bias. The overall quality of evidence will be rated with the Grading of Recommendations Assessment, Development and Evaluation framework. Data analysis will be conducted using Stata V.14.0.Ethics and disseminationEthics approval is not required. We plan to submit the results of this study to a peer-review journal.PROSPERO registration numberCRD42019119157.

scholarly journals Imeglimin, a novel, first in-class, blood glucose-lowering agent: a systematic review and meta-analysis of clinical evidence

2020 ◽  
Vol 20 (1) ◽  
pp. 28-31 ◽  
Author(s):  
Thomas SJ Crabtree ◽  
Ralph A DeFronzo ◽  
Robert E J Ryder ◽  
Clifford J Bailey
Keyword(s):  
Systematic Review ◽  
Blood Glucose ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Meta Analysis ◽  
Total N ◽  
Glucose Lowering ◽  
Fasting Plasma ◽  
Increase Glucose Uptake ◽  
Glucose Output

Imeglimin is a novel, first in-class, blood glucose-lowering agent which acts via a mitochondrial mechanism to enhance glucose-induced insulin secretion, decrease hepatic glucose output and increase glucose uptake by skeletal muscle. A systematic review and meta-analysis of randomised controlled clinical trials (RCTs) with imeglimin in adults with type 2 diabetes was undertaken. Of 45 articles identified, five were RCTs but, due to the format of the data, only three could be combined in a meta-analysis (total n=180 participants). A random-effects model found that imeglimin 1500 mg twice daily as monotherapy and add-on to metformin or sitagliptin was associated with reductions of HbA1c by −0.63% (95% CI −0.84 to −0.42) (−6.6 mmol/mol, 95% CI −8.8 to −4.4) and reductions of fasting plasma glucose by −0.52 mmol/L (95% CI −0.80 to −0.24) compared with placebo. Adverse events were minimal, mostly gastrointestinal, and without hypoglycaemia. It is concluded that imeglimin displays promising improvements in HbA1c and fasting plasma glucose and is generally well tolerated.

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