Department of Endocrinology, Huashan Hospital, Fudan University, Shanghai, China.
Diabetes Obes Metab. 2018 Apr;20(4):1024-1028. doi: 10.1111/dom.13140. Epub 2017 Nov 26.
The aim of this study was to systematically evaluate the efficacy and safety of anti-interleukin-1 therapy for type 2 diabetes. A literature search of PubMed and Embase for available trials on anti-interleukin-1 therapy in type 2 diabetes was performed. The baseline characteristics, changes in HbA1c and other metabolic parameters, and adverse events were extracted from included randomized controlled trials (RCTs) and were analysed with Review Manager. Mean differences (MDs) and 95% confidence intervals (Cis) were calculated to measure differences in metabolic parameters. Odds ratio and 95% CIs were calculated for adverse event rates. Five RCTs were included in the current meta-analysis with 357 subjects undergoing anti-interleukin-1 therapy (IL-1 receptor antagonist or anti-IL-1beta antibody) and 221 controls who received placebo. The HbA1c decrement (%) of anti-interleukin-1 group was significantly higher than that of the placebo group (MD = 0.23; 95% CI, -0.39 to -0.07; P = .005). AUC of C-peptide was improved also (MD = 14.55; 95% CI, 1.81-27.28; P = .03) after anti-interleukin-1 intervention. There was no difference in the rate of adverse events (odds ratio,1.16; 95% CI, 0.90-1.49; P = .25) between 2 groups. Anti-interleukin-1 therapy has mild hypoglycaemic effect in type 2 diabetes.
本研究旨在系统评价抗白细胞介素-1 治疗 2 型糖尿病的疗效和安全性。对 PubMed 和 Embase 中关于 2 型糖尿病抗白细胞介素-1 治疗的可用试验进行了文献检索。从纳入的随机对照试验(RCT)中提取基线特征、HbA1c 和其他代谢参数的变化以及不良事件,并使用 Review Manager 进行分析。采用均数差(MD)和 95%置信区间(CI)来衡量代谢参数的差异。计算不良反应发生率的比值比(OR)和 95%CI。目前的荟萃分析纳入了 5 项 RCT,共 357 名接受抗白细胞介素-1 治疗(白细胞介素-1 受体拮抗剂或抗白细胞介素-1β 抗体)的受试者和 221 名接受安慰剂的对照者。抗白细胞介素-1 组的 HbA1c 降低(%)明显高于安慰剂组(MD=0.23;95%CI,-0.39 至 -0.07;P=0.005)。抗白细胞介素-1 干预后 C 肽 AUC 也得到改善(MD=14.55;95%CI,1.81-27.28;P=0.03)。两组不良事件发生率无差异(OR,1.16;95%CI,0.90-1.49;P=0.25)。抗白细胞介素-1 治疗在 2 型糖尿病中具有轻微的降血糖作用。