摘要
目的系统评价坎格列净(canagliflozin)在二联或三联用药中治疗2型糖尿病的疗效和安全性。方法计算机检索Pub Med、Embase、Medline、Cochrane图书馆、CNKI、万方、维普、CBM共8个数据库,按Cochrane系统评价的方法评价纳入研究质量,并使用Rev Man5.2软件进行Meta分析。结果纳入符合标准的随机对照试验4个,共计患者3 961例。Meta分析结果显示,在二联或三联用药中,坎格列净降糖化血红蛋白疗效与西格列汀和格列美脲相当[MD=-0.15,95%CI(-0.30,-0.00),P=0.05;MD=-0.06,95%CI(-0.14,0.01),P=0.1],降体重作用优于西格列汀和格列美脲[MD=-2.67,95%CI(-2.96,-2.38),P<0.000 01;MD=-5.15,95%CI(-5.54,-4.76),P<0.000 01]。安全性方面,坎格列净引起低血糖事件的风险和西格列汀相当[RR=1.34,95%CI(0.94,1.92),P=0.11],与格列美脲相比风险更低[RR=0.16,95%CI(-0.12,-0.21),P<0.000 01]。结论在二联或三联用药中,坎格列净降低患者糖化血红蛋白的疗效与西格列汀和格列美脲相当,但可显著降低患者体重,发生低血糖事件的风险与西格列汀相当,而低于格列美脲。
AIM To evaluate the curative effect and safety of c triple therapy. METHODS Eight databases were searched, including anagliflozin for type 2 diabetes PubMed, Embase, Medline, in dual or Cochrane Library, CNKI, WanFang, VIP and CBM. The quality of randomized controlled trials （RCTs） was assessed according to the methods of Cochrane systematic review. Meta- analysis was performed by using Revman 5.2 software. RESULTS Four RCTs involving 3 961 patients were included. In dual or triple therapy, canagliflozin relative to sitagliptin or glimepiride provided similar reduction in HbAlo [MD = -0.15, 95%CI （-0.30, -0.00）,P = 0.05; MD -- -0.06, 95%CI （-0.14, 0.01）, P = 0.1] and provided significant higher reduction in body weight [MD =-2.67, 95%CI （-2.96, -2.38）, P〈 0.000 01; MD =-5.15, 95%CI （-5.54, -4.76）, P〈 0.000 01] . In aspect of safety, there were no significant differences between canagliflozin and sitagliptin in hypoglycaemia [RR = 1.34, 95%CI （0.94, 1.92） , P -- 0.11] And canagliflozin led to lower risk of hypoglycaemia [RR = 0.16, 95%CI （-0.12, -0.21）, P 〈 0.000 01] compared with glimepiride. CONCLUSION In dual or triple therapy, canagliflozin leads to non- superior reduction in HbAlo relative to sitagliptin or glimepiride, but higher reduction in body weight. The risk of hypoglycaemia of canagliflozin is similar to sitagliptin, and lower compared with glimepiride.
出处
《中国新药与临床杂志》
CAS
CSCD
北大核心
2015年第6期448-454,共7页
Chinese Journal of New Drugs and Clinical Remedies
关键词
坎格列净
糖尿病
2型
降血糖药
META分析
钠-葡萄糖转运蛋白类
canagliflozin
diabetes mellitus, type 2
hypoglycemic agents
meta-analysis
sodium-glucose transport proteins
