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Linagliptin Versus Sitagliptin in Patients With Type 2 Diabetes Mellitus: A Network Meta-Analysis of Randomized Clinical Trials Publisher Pubmed



Keshavarz K1 ; Lotfi F1 ; Sanati E2 ; Salesi M3 ; Hashemimeshkini A2 ; Jafari M1 ; Mojahedian MM2 ; Najafi B4 ; Nikfar S5
Authors
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Authors Affiliations
  1. 1. Health Human Resources Research Center, Department of Health Economics, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR, Iran
  2. 2. Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, IR, Iran
  3. 3. Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR, Iran
  4. 4. Iranian Center of Excellence in Health Management, Department of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
  5. 5. Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy and Evidence-Based Medicine Group, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran

Source: DARU# Journal of Pharmaceutical Sciences Published:2017


Abstract

Background: Diabetes is one of the most common chronic and costly diseases worldwide and type 2 diabetes is the most common type which accounts for about 90% of cases with diabetes. New medication-therapy regimens such as those containing linagliptin alone or in combination with other medications (within the category of DDP-4 inhibitors) must be evaluated in terms of efficacy and compared with other currently used drugs and then enter the medication list of the country. Hence, this study aimed to compare the clinical efficacy of the two drugs, i.e. linagliptin and sitagliptin, in patients with type 2 diabetes. Methods: A systematic review was conducted to identify all clinical trials published by 2015 which compared the two drugs in patients with type 2 diabetes. Using keywords such as linagliptin, type 2 diabetes mellitus, sitagliptin and related combinations, we searched databases including Scopus, PubMed, and Web of Science. The quality of the selected studies was evaluated using the Jadad score. Considering primary and secondary outcomes extracted from the reviewed studies, a network meta-analysis was used to conduct a systematic comparison between the two studied drugs. Results: This network meta-analysis included 32 studies (Linagliptin vs PLB: n = 8, Sitagliptin vs PLB: n = 13, Linagliptin + MET vs PLB + MET: n = 4, and Sitagliptin + MET vs PLB + MET: n = 7) and a total of 13,747 patients. The results showed no significant difference between linagliptin and sitagliptin in terms of key efficacy and safety outcomes such as HbA1c changes from baseline, body weight change from baseline, percentage of patients achieving HbA1c <7, and percentage of patients experiencing hypoglycemic events (p > 0.05). The results showed that the efficacy of the two drug regimens was the same. Conclusions: Based on the results, there was no significant difference between the two drugs, i.e. linagliptin and sitagliptin, in terms of efficacy; in other words, the efficacy of the two drugs was the same. Therefore, the use of these two drugs depends on their availability and cost. Graphical abstract: Graphical abstract of the network meta-analysis performed to evaluate the alternatives under the study.[Figure not available: see fulltext.] © 2017 The Author(s).
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