Department of Pharmacy, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China.
Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, USA.
Diabetes Res Clin Pract. 2022 Jan;183:109080. doi: 10.1016/j.diabres.2021.109080. Epub 2021 Oct 7.
AIMS: This network meta-analysis aimed to evaluate the asthma risk associated with dipeptidyl peptidase (DPP)-4 inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs), and sodium-glucose co-transporter (SGLT) 2 inhibitors. METHODS: Electronic databases were systematically searched up to March 2021 to include placebo-controlled cardiovascular (or cardiorenal) outcome trials that reported the asthma incidents in patients taking DPP-4 inhibitors, GLP-1RAs, or SGLT2 inhibitors. A random-effects network meta-analysis was conducted to estimate their odds ratio (ORs) and 95% confidence intervals (CIs). RESULTS: Nineteen trials including 218 asthma cases among 159,705 patients were included. Compared with placebo, SGLT2 inhibitors (OR, 0.59; 95% CI, 0.38-0.93) were significantly associated with a decreased risk of asthma while both DPP-4 inhibitors and GLP-1RAs did not significantly affect asthma risk. SGLT2 inhibitors were significantly associated with a lower risk of asthma than DPP-4 inhibitors (OR, 0.38; 95% CI, 0.18-0.79). There was no association between GLP-1RAs and DPP-4 inhibitors and between SGLT2 inhibitors and GLP-1RAs in risk of asthma. CONCLUSIONS: SGLT2 inhibitors might protect against asthma while DPP-4 inhibitors and GLP-1RAs did not significantly affect the asthma incident. Given the underreporting of asthma in this study, further investigations using real-world data as well as mechanistic studies are warranted to confirm our results.
目的:本网络荟萃分析旨在评估二肽基肽酶(DPP)-4 抑制剂、胰高血糖素样肽-1 受体激动剂(GLP-1RA)和钠-葡萄糖协同转运蛋白(SGLT)2 抑制剂与哮喘风险的相关性。
方法:系统检索电子数据库,截至 2021 年 3 月,纳入报告 DPP-4 抑制剂、GLP-1RA 或 SGLT2 抑制剂治疗患者哮喘事件的安慰剂对照心血管(或心肾)结局试验。采用随机效应网络荟萃分析估计其比值比(OR)和 95%置信区间(CI)。
结果:纳入 19 项试验,共纳入 159705 例患者中的 218 例哮喘病例。与安慰剂相比,SGLT2 抑制剂(OR,0.59;95%CI,0.38-0.93)与哮喘风险降低显著相关,而 DPP-4 抑制剂和 GLP-1RA 均未显著影响哮喘风险。SGLT2 抑制剂与 DPP-4 抑制剂相比,哮喘风险显著降低(OR,0.38;95%CI,0.18-0.79)。GLP-1RA 与 DPP-4 抑制剂之间、SGLT2 抑制剂与 GLP-1RA 之间均无哮喘风险相关性。
结论:SGLT2 抑制剂可能预防哮喘,而 DPP-4 抑制剂和 GLP-1RA 对哮喘事件的发生无显著影响。鉴于本研究中哮喘的报告不足,需要进一步使用真实世界数据和机制研究来证实我们的结果。
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