Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fudan University, No. 826 Zhangheng Road, Pudong New District, Shanghai, 201203, China.
Qual Life Res. 2024 Dec;33(12):3175-3188. doi: 10.1007/s11136-024-03753-6. Epub 2024 Aug 3.
To evaluate the impact of dipeptidyl peptidase 4 (DPP-4) inhibitors on Health-related quality of life (HRQOL) in patients with type 2 diabetes mellitus (T2DM) compared with other hypoglycemic agents.
A systematic review and meta-analysis based on randomized controlled trials was conducted following the Cochrane Handbook and PRISMA. Studies were identified by searching PubMed (MEDLINE), EMBASE, Web of Science, CNKI, WANGFANG DATA, VIP DATABASE, Google Scholar, and Cochrane Central Register of Controlled Trials from database inception to Dec 30, 2023. The main result was HRQOL scores. The outcomes were extracted using the mean difference (MD) from each study. Sensitivity analysis and subgroup analysis were also performed.
Forty studies (4,579 participants) were included, with 32 pooled for meta-analysis. DPP-4 inhibitors alongside conventional treatment significantly enhanced HRQOL compared to conventional treatment alone (MD = 9.85, 95% CI [7.98-11.71], P < 0.001; heterogeneity, I = 94%, P < 0.001), as assessed by SF-36 using a random-effects model. No additional benefit was found when measured by DTR-QOL using a fixed-effects model (MD = 2.29, 95% CI [-0.06-4.64], P = 0.06; heterogeneity, I = 49%, P = 0.1) and compared to SGLT-2 inhibitors. Subgroup analysis indicated that DPP-4 inhibitors favored patients ≥ 60 years old on medication for ≥ 6 months.
DPP-4 inhibitors were superior for T2DM HRQOL improvement. More long-term, multicenter evidence is needed to generalize findings and compare them with newer hypoglycemic agents.
PROSPERO: CRD42023440134.
评估二肽基肽酶 4（DPP-4）抑制剂与其他降糖药物相比，在 2 型糖尿病（T2DM）患者中的健康相关生活质量（HRQOL）的影响。
根据 Cochrane 手册和 PRISMA 进行了基于随机对照试验的系统评价和荟萃分析。通过检索 PubMed（MEDLINE）、EMBASE、Web of Science、中国知网（CNKI）、万方数据、维普数据库、VIP 数据库、谷歌学术和 Cochrane 对照试验中心注册库，从数据库建立到 2023 年 12 月 30 日，确定了研究。主要结果是 HRQOL 评分。使用每项研究的均数差（MD）提取结果。还进行了敏感性分析和亚组分析。
共纳入 40 项研究（4579 名参与者），其中 32 项进行了荟萃分析。与单独使用常规治疗相比，DPP-4 抑制剂联合常规治疗显著提高了 HRQOL（MD=9.85，95%CI[7.98-11.71]，P<0.001；异质性，I=94%，P<0.001），采用随机效应模型评估 SF-36。采用固定效应模型评估 DTR-QOL 时，未发现额外获益（MD=2.29，95%CI[-0.06-4.64]，P=0.06；异质性，I=49%，P=0.1），与 SGLT-2 抑制剂相比也没有获益。亚组分析表明，DPP-4 抑制剂对≥60 岁且服药≥6 个月的患者更为有利。
DPP-4 抑制剂在改善 T2DM HRQOL 方面更具优势。需要更多的长期、多中心证据来推广发现并与新的降糖药物进行比较。
PROSPERO：CRD42023440134。
