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奥马利格列汀的疗效和安全性,一种新型的每周一次的二肽基肽酶-4 抑制剂,在 2 型糖尿病中的应用:系统评价和荟萃分析。

Efficacy and Safety of Omarigliptin, a Novel Once-Weekly Dipeptidyl Peptidase-4 Inhibitor, in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.

机构信息

Department of Endocrinology, Mymensingh Medical College, Mymensingh, Bangladesh.

Department of Medicine, Army Medical College Cumilla, Cumilla, Bangladesh.

出版信息

Endocrinol Metab (Seoul). 2024 Feb;39(1):109-126. doi: 10.3803/EnM.2023.1839. Epub 2024 Jan 23.

Abstract

BACKGRUOUND

No recent meta-analysis has holistically analyzed and summarized the efficacy and safety of omarigliptin in type 2 diabetes mellitus (T2DM). We conducted a meta-analysis to address this knowledge gap.

METHODS

Electronic databases were searched to identify randomized controlled trials (RCTs) that included patients with T2DM who received omarigliptin in the intervention arm. The control arm consisted of either a placebo (passive control group [PCG]) or an active comparator (active control group [ACG]). The primary outcome assessed was changes in hemoglobin A1c (HbA1c), while secondary outcomes included variations in glucose levels, achievement of glycemic targets, adverse events (AEs), and hypoglycemic events.

RESULTS

From 332 initially screened articles, data from 16 RCTs involving 8,804 subjects were analyzed. Omarigliptin demonstrated superiority over placebo in reducing HbA1c levels (mean difference, -0.58%; 95% confidence interval, -0.75 to -0.40; P<0.00001; I2=91%). Additionally, omarigliptin outperformed placebo in lowering fasting plasma glucose, 2-hour postprandial glucose, and in the percentage of participants achieving HbA1c levels below 7.0% and 6.5%. The glycemic efficacy of omarigliptin was similar to that of the ACG across all measures. Although the omarigliptin group experienced a higher incidence of hypoglycemic events compared to the PCG, the overall AEs, serious AEs, hypoglycemia, and severe hypoglycemia were comparable between the omarigliptin and control groups (PCG and ACG).

CONCLUSION

Omarigliptin has a favorable glycemic efficacy and safety profile for managing T2DM.

摘要

背景

目前尚无综合分析和总结 Omarigliptin 在 2 型糖尿病(T2DM)中的疗效和安全性的荟萃分析。我们进行了一项荟萃分析以解决这一知识空白。

方法

检索电子数据库以确定包含接受 Omarigliptin 治疗的 T2DM 患者的随机对照试验(RCT)。对照组为安慰剂(被动对照组 [PCG])或活性对照剂(活性对照组 [ACG])。主要结局评估是血红蛋白 A1c(HbA1c)的变化,次要结局包括血糖水平的变化、血糖控制目标的实现、不良事件(AE)和低血糖事件。

结果

从最初筛选的 332 篇文章中,分析了 16 项 RCT 共 8804 名受试者的数据。与安慰剂相比, Omarigliptin 降低 HbA1c 水平的疗效更优(平均差异,-0.58%;95%置信区间,-0.75 至-0.40;P<0.00001;I2=91%)。此外,与安慰剂相比, Omarigliptin 还能降低空腹血糖、餐后 2 小时血糖以及达到 HbA1c 水平<7.0%和<6.5%的参与者比例。Omarigliptin 在所有指标上的降糖疗效与 ACG 相似。虽然 Omarigliptin 组的低血糖事件发生率高于 PCG,但 Omarigliptin 组和对照组(PCG 和 ACG)的总体 AE、严重 AE、低血糖和严重低血糖发生率相当。

结论

Omarigliptin 在治疗 T2DM 方面具有良好的血糖疗效和安全性。

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