The effect and safety of diacerein in patients with type 2 diabetes mellitus : a systematic review and meta-analysis.

UNLABELLED

The Background: Diacerein has been proposed as a treatment option for management of type 2 diabetes due to its anti-inflammatory properties.

PURPOSE

The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) is to examine the effect and safety of diacerein in patients with type 2 diabetes.

DATA SOURCES AND STUDY SELECTION

We searched Pubmed, Embase, and Cochrane Library for RCTs published from database inception to September 2017.

DATA EXTRACTION AND DATA SYNTHESIS

Among 44 studies that were initially identified, four were eligible and were included in the following analysis. Diacerein significantly reduced fasting glycemia [weighted mean differences (WMD) -0.66, 95% confidence interval (95% CI) -1.16 to -0.16] and glycated hemoglobin A1c (HbA1c ) (WMD -0.85, 95% CI -1.44 to -0.26). And the patients with a diacerein supplementation duration of ≤12 weeks had a greater decrease of fasting glycemia and HbA1c than the supplementation duration of >12 weeks. Furthermore, compared with placebo, diacerein revealed a significant increase in the relative risk (RR) of gastrointestinal symptoms (RR=2.50, 95% CI: 1.10 to 5.65), especially in the study subgroup with supplementation duration of >12 weeks (RR=4.01, 95% CI: 2.32 to 6.95).

LIMITATIONS

The sample size was relatively small and the duration of included studies was short so that the treatment efficacy and safety for longer duration was unknown.

CONCLUSIONS

Although further studies are needed, our findings clearly provide support to the use of diacerein in the clinical management of subjects with type 2 diabetes.