Taheri Saeed, Saffaei Ali, Amani Bahman, Akbarzadeh Arash, Peiravian Farzad, Yousefi Nazila
Department of Pharmacoeconomics and Pharmaceutical Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iran J Pharm Res. 2019 Fall;18(4):2180-2190. doi: 10.22037/ijpr.2019.14733.12619.
Diabetes mellitus has been always one of the most prevalent chronic diseases in the last decades. There exist a wide range of pharmacological agents for controlling this disease. However, these agents fare differently in terms of efficacy and safety. Hence, the aim of this study was to compare dulaglutide and liraglutide, two glucagon-like peptide-1 receptor agonists, in terms of efficacy and safety, drawing on a systematic review and meta-analysis. A systematic review and meta-analysis were carried out in January 2018. The articles were evaluated by two independent investigators and their quality was evaluated using Jadad scale and the Cochrane Collaboration's tools. Finally, the eligible articles entered the study. HbA1c and FBS were considered as efficacy outcomes. Safety profile was evaluated based on several outcomes such as serious side effects and vital signs. Three articles met the inclusion and exclusion criteria. The results indicated that the mean difference (MD) of HbA1c reduction was -0.10% (95% CI, -0.20% to -0.01%, P=0.03) in the patients who received dulaglutide in comparison with the patients who received liraglutide. In addition, dulaglutide was safer than liraglutide in terms of gastrointestinal problems (RR=0.85, 95% CI, 0.73 to 0.99, P=0.04, I=55%) and heart rate (RR=-1.14, 95% CI, -1.90 to -0.38, P=0.003, I=0%). Once-weekly dulaglutide showed a further reduction in HbA1c compared to once-daily liraglutide. However, comparisons between these regimens indicated no significant difference between groups in either FBS reduction or safety profile. Similarly, no statistically significant difference was observed in treatment discontinuation, hypoglycemia events, and vital signs.
在过去几十年中，糖尿病一直是最普遍的慢性疾病之一。有多种控制这种疾病的药物。然而，这些药物在疗效和安全性方面表现各异。因此，本研究旨在通过系统评价和荟萃分析，比较两种胰高血糖素样肽-1受体激动剂度拉糖肽和利拉鲁肽在疗效和安全性方面的差异。2018年1月进行了一项系统评价和荟萃分析。文章由两名独立研究者进行评估，并使用Jadad量表和Cochrane协作组的工具对其质量进行评估。最后，符合条件的文章纳入研究。糖化血红蛋白（HbA1c）和空腹血糖（FBS）被视为疗效指标。基于严重副作用和生命体征等多个指标评估安全性。三篇文章符合纳入和排除标准。结果表明，与接受利拉鲁肽的患者相比，接受度拉糖肽的患者糖化血红蛋白降低的平均差值（MD）为-0.10%（95%可信区间，-0.20%至-0.01%，P=0.03）。此外，在胃肠道问题（相对危险度RR=0.85，95%可信区间，0.73至0.99，P=样性指数I=55%）和心率（RR=-1.14，95%可信区间，-1.90至-0.38，P=0.003，I=0%）方面，度拉糖肽比利拉鲁肽更安全。与每日一次的利拉鲁肽相比，每周一次的度拉糖肽使糖化血红蛋白进一步降低。然而，这些治疗方案之间的比较表明，在空腹血糖降低或安全性方面，两组之间无显著差异。同样，在治疗中断、低血糖事件和生命体征方面未观察到统计学上的显著差异。 04，异
