Department of Endocrinology, Mymensingh Medical College, Mymensingh, Bangladesh.
Department of Endocrinology, CEDAR Superspeciality Healthcare, Dwarka, New Delhi, India.
Medicine (Baltimore). 2024 Jul 12;103(28):e38870. doi: 10.1097/MD.0000000000038870.
No comprehensive meta-analysis has examined and consolidated the effectiveness and safety of anagliptin in treating type 2 diabetes mellitus (T2D). To bridge this knowledge gap, we undertook this meta-analysis.
Randomized controlled trials involving patients with T2D receiving anagliptin were sought after through electronic databases. The control arm consisted of either an active comparator (active control group [ACG]) or a placebo (passive control group [PCG]). The primary outcome was glycated hemoglobin (HbA1c), with secondary outcomes including fasting plasma glucose (FPG) and lipid profiles and adverse events.
From the 226 articles first examined, 10 randomized controlled trials with 970 participants were analyzed. Reductions in HbA1c (mean difference [MD]: -0.03%, 95% confidence interval [CI]: -0.14 to 0.14, P = .51, I2 = 9%) and FPG (MD: 0.03 mmol/L, 95% CI: -0.30 to 0.35, P = .87, I2 = 42%) were similar in the anagliptin group and ACG. Anagliptin reduced FPG better than placebo (MD: -1.25 mmol/L, 95% CI: -1.87 to -0.64, P < .0001, I2 = 0%). Sufficient data were unavailable to analyze the HbA1c lowering with anagliptin versus placebo. Among the lipid parameters, changes in total cholesterol, high-density lipoprotein cholesterol, apolipoprotein B48, and apolipoprotein B100 were identical between the anagliptin and control groups (PCG and ACG). Anagliptin was better than ACG at lowering low-density lipoprotein cholesterol but not as good at lowering triglyceride. Adverse events were infrequent and similar in the anagliptin and control groups (PCG and ACG).
Anagliptin positively affects glucose control and is safe for managing T2D. Its low-density lipoprotein cholesterol-lowering effect warrants further investigation.
目前尚无综合的荟萃分析来评估阿格列汀治疗 2 型糖尿病（T2DM）的疗效和安全性。为了填补这一知识空白，我们进行了本次荟萃分析。
通过电子数据库检索了涉及接受阿格列汀治疗的 T2DM 患者的随机对照试验。对照组由活性对照（活性对照组[ACG]）或安慰剂（被动对照组[PCG]）组成。主要结局为糖化血红蛋白（HbA1c），次要结局包括空腹血糖（FPG）和血脂谱以及不良事件。
从最初检查的 226 篇文章中，分析了 10 项随机对照试验，共纳入 970 名参与者。阿格列汀组与 ACG 组的 HbA1c（平均差值[MD]：-0.03%，95%置信区间[CI]：-0.14 至 0.14，P=0.51，I2=9%）和 FPG（MD：0.03 mmol/L，95%CI：-0.30 至 0.35，P=0.87，I2=42%）降低情况相似。阿格列汀降低 FPG 的效果优于安慰剂（MD：-1.25 mmol/L，95%CI：-1.87 至 -0.64，P<0.0001，I2=0%）。没有足够的数据来分析阿格列汀与安慰剂相比对 HbA1c 的降低作用。在血脂参数方面，阿格列汀组与对照组（PCG 和 ACG）的总胆固醇、高密度脂蛋白胆固醇、载脂蛋白 B48 和载脂蛋白 B100 的变化相同。阿格列汀降低 LDL-C 的效果优于 ACG，但降低甘油三酯的效果不如 ACG。不良事件在阿格列汀组和对照组（PCG 和 ACG）中均不常见且相似。
阿格列汀对血糖控制有积极影响，且在治疗 T2DM 方面是安全的。其降低 LDL-C 的作用值得进一步研究。
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