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:: Volume 18, Issue 1 (spring 2018) ::
J Ardabil Univ Med Sci 2018, 18(1): 21-33 Back to browse issues page
Comparison of Therapeutic Effects of Linagliptin and Metformin in Patients with Type 2 Diabetes: A systematic Review and Meta-Analysis
Hamidreza Dehghan , Masoud Mirzaei , Ebrahim Mirzaei , Eslam Moradei Asl , Amin Ataiy , Mahbobeh Mirzaei
Department of Health Technology Assessment, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Abstract:   (452 Views)
Background & objectives: Type 2 diabetes mellitus (DM) is a metabolic disorder that is common throughout the world. Meta-analysis is a statistical technique in which the results of two or more independent studies, with similar objectives, are mathematically combined in order to improve the reliability of the results. The aim of this study was to compare the efficacy of metformin and linagliptin in patients with type 2 diabetes.
Methods: To identify relevant studies, PubMed, ISI Web of Science, Embase, Cochran library, Scopus and Ovid databases were searched from January 2000 to August 2016. Mean difference (MD) with 95% confidence interval (CI) for efficacy were calculated and pooled analysis was performed using Stata V.12 and RevMan V.5.3 software.
Results: Four studies recruiting1260 patients with DM (682 patients in group linagliptin and 578 patients in metformin group) were included in this study. The MD of HbA1C outcome of 0.5 mg linagliptin was effective (0. 7295, % CI = 0. 69 - 0. 75). The MD of fasting blood sugar (FBS) test revealed that linagliptin was effective at 0.5mg (MD = 36.79, 95% CI = 35.20 - 38.38) and 5 mg (MD = 12.65, 95% CI = 2.68 to 22.63) doses.
Conclusion: Our results suggest that some doses of linagliptin versus metformin may be an effective treatment for DM2. However, the number of studies was limited, and further research is needed.
Keywords: Linagliptin, Metformin, Type 2 Diabetes, Safety, Treatment
Full-Text [PDF 208 kb]   (105 Downloads)    
Type of Study: review article | Subject: General
Received: 2017/12/22 | Accepted: 2018/03/11 | Published: 2018/03/29
1. Aghamollaei T, Eftekhar H, Mohammad K, Nakhjavani M, Shojaezadeh D, Ghofranipour F, et al. Effects of a health education program on behavior, HBA1c and health-related quality of life in diabetic patients. Acta Medical Iranica 2005; 43(2): 89-94.
2. Tsirona S, Katsaros F, Bargiota A, Polyzos SA, Arapoglou G, Koukoulis GN. Prevalence and determinants of type 2 diabetes mellitus in a Greek adult population. Hormones. 2016 Jan-Mar 15 (1):88-98. [DOI:10.14310/horm.2002.1662]
3. Frostegård J, Ulfgren AK, Nyberg P, Hedin U, Swedenborg J, Andersson U, et al. Cytokine expression in advanced human atherosclerotic plaques: dominance of pro-inflammatory (Th1) and macrophage-stimulating cytokines. Atherosclerosis. 1999 Jul;145 (1):33-43. [DOI:10.1016/S0021-9150(99)00011-8]
4. Nathan DM, Buse JB, Davidson MB, Heine RJ, Holman RR, Sherwin R, et al. Management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes care. 2006 Aug;29 (8):1963-72. [DOI:10.2337/dc06-9912]
5. Gæde P, Vedel P, Larsen N, Jensen GV, Parving HH, Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med. 2003 Jan;348 (5):383-93. [DOI:10.1056/NEJMoa021778]
6. American Diabetes Association. Economic costs of diabetes in the US in 2012. Diabetes care. 2013 Apr;36 (4):1033-46. [DOI:10.2337/dc12-2625]
7. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2011 Jun; 34(Suppl 1): S11–S61. [DOI:10.2337/dc11-S011]
8. Evans JM, Donnelly LA, Emslie-Smith AM, Alessi DR, Morris AD. Metformin and reduced risk of cancer in diabetic patients. BMJ. 2005 Jun 2;330 (7503):1304-5. [DOI:10.1136/bmj.38415.708634.F7]
9. Correia S, Carvalho C, Santos MS, Seiça R, Oliveira CR, Moreira PI. Mechanisms of action of metformin in type 2 diabetes and associated complications: an overview. Mini reviews in medicinal chemistry. 2008 Nov 1;8 (13):1343-54. [DOI:10.2174/138955708786369546]
10. Ravandi F, Estey E, Jones D, Faderl S, O'Brien S, Fiorentino J, et al. Effective treatment of acute promyelocytic leukemia with all-trans-retinoic acid, arsenic trioxide, and gemtuzumab ozogamicin. J Clin Oncol. 2009 Feb;27 (4):504-10. [DOI:10.1200/JCO.2008.18.6130]
11. Zhou G, Myers R, Li Y, Chen Y, Shen X, Fenyk-Melody J, et al. Role of AMP-activated protein kinase in mechanism of metformin action. J Clin Invest. 2001 Oct;108 (8):1167-74. [DOI:10.1172/JCI13505]
12. Moll E, van der Veen F, van Wely M. The role of metformin in polycystic ovary syndrome: a systematic review. Hum Reprod Update. 2007 Nov-Dec;13 (6):527-37. [DOI:10.1093/humupd/dmm026]
13. Maruthur NM, Tseng E, Hutfless S, Wilson LM, Suarez-Cuervo C, Berger Z, et al. Diabetes medications as monotherapy or metformin-based combination therapy for type 2 diabetes: a systematic review and meta-analysis. Ann Intern Med. 2016 Jun;164 (11):740-51. [DOI:10.7326/M15-2650]
14. Eli Lilly and company. FDA approves first-in-class Glyxambi (empagliflozin/linagliptin) tablets for adults with type 2 diabetes. Press release. February 2 [Online]. Available: http://lilly.mediaroom.com/ index.php?s=9042&item=137386. Accessed February 25, 2015.
15. Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, et al. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes care. 2015 Jan;38 (1):140-9. [DOI:10.2337/dc14-2441]
16. DeFronzo RA, Lewin A, Patel S, Liu D, Kaste R, Woerle HJ, et al. Combination of empagliflozin and linagliptin as second-line therapy in subjects with type 2 diabetes inadequately controlled on metformin. Diabetes care. 2015 Mar; 38 (3):384-93. [DOI:10.2337/dc14-2364]
17. Singh‐Franco D, McLaughlin‐Middlekauff J, Elrod S, Harrington C. The effect of linagliptin on glycaemic control and tolerability in patients with type 2 diabetes mellitus: a systematic review and meta‐analysis. Diabetes Obes Metab. 2012 Aug;14 (8):694-708. [DOI:10.1111/j.1463-1326.2012.01586.x]
18. Terawaki Y, Nomiyama T, Takahashi H, Tsutsumi Y, Murase K, Nagaishi R, et al. Efficacy of dipeptidyl peptidase-4 inhibitor linagliptin in patients with type 2 diabetes undergoing hemodialysis. Diabetol Metab Syndr. 2015 May;7:44. [DOI:10.1186/s13098-015-0043-2]
19. Freeman JS. A physiologic and pharmacological basis for implementation of incretin hormones in the treatment of type 2 diabetes mellitus. Mayo Clin Proc. 2010 Dec; 85 (12 Suppl): S5-S14. [DOI:10.4065/mcp.2010.0467]
20. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS medicine. 2009 Jul;6 (7):e1000100. [DOI:10.1371/journal.pmed.1000100]
21. Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011 Oct;343:d5928. [DOI:10.1136/bmj.d5928]
22. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996 Feb;17 (1):1-12. [DOI:10.1016/0197-2456(95)00134-4]
23. Ross SA, Rafeiro E, Meinicke T, Toorawa R, Weber-Born S, Woerle HJ. Efficacy and safety of linagliptin 2.5 mg twice daily versus 5 mg once daily in patients with type 2 diabetes inadequately controlled on metformin: a randomised, double-blind, placebo-controlled trial. Curr Med Res Opin. 2012 Sep;28 (9):1465-74. [DOI:10.1185/03007995.2012.714360]
24. Ingellheim B. Safety and Efficacy of Linagliptin (BI 1356) Plus Metformin in Type 2 Diabetes, Factorial Design [Online]. 2013: Available from:https://clinicaltrials.gov/ct2/show/ NCT00798161?term=NCT00798161&rank=1.
25. Boehringer I, Elil, & Company. Study to Compare the Efficacy and Safety of Administration of the Fix Dose Combination of Linagliptin Plus Metformin in Drug naïve Type 2 Patients ] Online].2015: Available from:https://clinicaltrials.gov/ct2/show/NCT01708902?term=NCT01708902&rank=1.
26. Boehringer I, Study CHair & Boehringer I. Efficacy and Safety of 3 Doses of BI1356 (Linagliptin) in Type 2 Diabetes Patients, NCT00328172 [Online]. 2014:Available from: https://clinicaltrials.gov/ct2/show/NCT00328172?term=NCT00328172&rank=1.
27. Gomis R, Espadero RM, Jones R, Woerle HJ, Dugi KA. Efficacy and safety of initial combination therapy with linagliptin and pioglitazone in patients with inadequately controlled type 2 diabetes: a randomized, double‐blind, placebo‐controlled study. Diabetes Obes Metab. 2011 Jul;13 (7):653-61. [DOI:10.1111/j.1463-1326.2011.01391.x]
28. Del Prato S, Barnett AH, Huisman H, Neubacher D, Woerle HJ, Dugi KA. Effect of linagliptin monotherapy on glycaemic control and markers of β‐cell function in patients with inadequately controlled type 2 diabetes: a randomized controlled trial. Diabetes Obes Metab. 2011 Mar;13 (3):258-67. [DOI:10.1111/j.1463-1326.2010.01350.x]
29. Taskinen MR, Rosenstock J, Tamminen I, Kubiak R, Patel S, Dugi KA, et al. Safety and efficacy of linagliptin as add‐on therapy to metformin in patients with type 2 diabetes: a randomized, double‐blind, placebo‐controlled study. Diabetes Obes Metab. 2011 Jan;13 (1):65-74. [DOI:10.1111/j.1463-1326.2010.01326.x]
30. Weinstein JN, Tosteson TD, Lurie JD, Tosteson AN, Hanscom B, Skinner JS, et al. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT): a randomized trial. JAMA. 2006 Nov;296 (20):2441-50. [DOI:10.1001/jama.296.20.2441]
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Dehghan H, Mirzaei M, Mirzaei E, Moradei Asl E, Ataiy A, Mirzaei M. Comparison of Therapeutic Effects of Linagliptin and Metformin in Patients with Type 2 Diabetes: A systematic Review and Meta-Analysis . J Ardabil Univ Med Sci. 2018; 18 (1) :21-33
URL: http://jarums.arums.ac.ir/article-1-1531-en.html

Volume 18, Issue 1 (spring 2018) Back to browse issues page
مجله دانشگاه علوم پزشکی اردبیل Journal of Ardabil University of Medical Sciences
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