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胰高血糖素样肽-1受体激动剂对2型糖尿病患者鼻咽炎和上呼吸道感染的影响:一项网状Meta分析

[Impact of glucagon-like peptide-1 receptor agonists on nasopharyngitis and upper respiratory tract infection among patients with type 2 diabetes: a network meta-analysis].

作者信息

Li Z X, Wu S S, Yang Z R, Zhan S Y, Sun F

机构信息

Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China.

National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2016 Jun 18;48(3):454-9.

Abstract

OBJECTIVE

To systematically review the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on two common respiratory system adverse events (RSAE: nasopharyngitis and upper respiratory tract infection) among type 2 diabetes (T2DM).

METHODS

Medline, Embase, Clinical trials and Cochrane library were searched from inception through May 2015 to identify randomized clinical trials(RCTs) assessed safety of GLP-1RAs versus placebo or other anti-diabetic drugs in T2DM. Network meta-analysis within a Bayesian framework was performed to calculate odds ratios for the incidence of RSAE.

RESULTS

In the study, 50 RCTs were included, including 13 treatments: 7 GLP-1RAs (exenatide, exenatide-long-release-agent, liraglutide, lixisenatide, taspoglutide, albiglutide and dulaglutide), placebo and 5 traditional anti-diabetic drugs(insulin, metformin, sulfonylureas, sitagliptin and thiazolidinediones ketones). Compared with insulin, taspoglutide significantly decreased the incidence of nasopharyngitis (OR=0.67, 95%CI: 0.46-0.96). Significant lowering effects on upper respiratory tract infection were found when taspoglutide versus placebo (OR=0.57, 95%CI: 0.34-0.99) and insulin (OR=0.39, 95%CI: 0.23-0.73). The result from the network meta-analysis based on Bayesian theory could be used to rank all the treatments included, which showed that taspoglutide ranked last with minimum risk on nasopharyngitis and upper respiratory tract infection.

CONCLUSION

Taspoglutide was associated with significantly lowering effect on RSAE.

摘要

目的

系统评价胰高血糖素样肽-1受体激动剂(GLP-1RAs)对2型糖尿病(T2DM)患者两种常见呼吸系统不良事件(RSAE:鼻咽炎和上呼吸道感染)的影响。

方法

检索Medline、Embase、临床试验数据库和Cochrane图书馆,检索时间从数据库建立至2015年5月,以识别评估GLP-1RAs与安慰剂或其他抗糖尿病药物在T2DM患者中安全性的随机临床试验(RCT)。在贝叶斯框架内进行网络荟萃分析,以计算RSAE发生率的比值比。

结果

本研究纳入50项RCT,包括13种治疗:7种GLP-1RAs(艾塞那肽、长效艾塞那肽、利拉鲁肽、利司那肽、塔司普明、阿必鲁肽和度拉鲁肽)、安慰剂和5种传统抗糖尿病药物(胰岛素、二甲双胍、磺脲类、西他列汀和噻唑烷二酮类)。与胰岛素相比,塔司普明显著降低鼻咽炎的发生率(OR=0.67,95%CI:0.46-0.96)。当塔司普明与安慰剂(OR=0.57,95%CI:0.34-0.99)和胰岛素(OR=0.39,95%CI:0.23-0.73)相比时,对上呼吸道感染有显著的降低作用。基于贝叶斯理论的网络荟萃分析结果可用于对所有纳入的治疗进行排序,结果显示塔司普明在鼻咽炎和上呼吸道感染方面风险最低,排名最后。

结论

塔司普明与显著降低RSAE有关。

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