中国循证医学杂志

中国循证医学杂志

DPP-4 抑制剂治疗 2 型糖尿病的系统评价再评价

查看全文

目的对已发表的二肽基肽酶-4(DPP-4)抑制剂治疗 2 型糖尿病的有效性和安全性的系统评价/Meta 分析进行再评价。方法计算机检索 The Cochrane Library、PubMed、EMbase、CBM、WanFang Data 和 CNKI 数据库,搜集基于 DPP-4 抑制剂治疗 2 型糖尿病的系统评价再评价,检索时限均为建库至 2016 年 12 月。由 2 位评价员独立筛选文献和提取资料后,采用 AMSTAR 量表和 PRISMA 声明评价纳入研究的方法学质量和报告质量。结果最终纳入 27 篇系统评价/Meta 分析。AMSTAR 平均分为 7.04 分,得分最差的为条目 1“是否提供了前期设计方案”(26 篇未提供)、条目 4“发表情况是否已考虑在纳入标准中”(10 篇未提供)、条目 10“是否评价发表偏倚的可能性”(15 篇未提供)和条目 11“是否说明相关利益冲突”(15 篇未提供)。PRISMA 清单评分为 17.0~24.5 分。报告质量存在的问题主要表现在方案与注册、文献检索、补充分析与资助来源方面。结论本研究结果显示 DPP-4 抑制剂治疗 2 型糖尿病的系统评价/Meta 分析的方法学质量和报告学质量均不高。

ObjectiveTo overview the systematic reviews/meta-analyses (SRs/MAs) of efficacy and safety of dipeptidyl peptidase-4 inhibitors (DPP-4) in treatment of type 2 diabetes mellitus (T2DM).MethodsDatabase including The Cochrane Library, PubMed, EMbase, CBM, WanFang Data and CNKI were searched from inception to December 2016 to collect SRs/MAs of randomized controlled trials (RCTs) of DPP-4 for the treatment of T2DM. Two reviewers independently screened literature, extracted data, and evaluated the reporting and methodological qualities using the PRISMA checklist and the AMSTAR tool.ResultsTwenty-seven SRs/MAs of DPP-4 for the treatment of T2DM were included in this overview. The average score of AMSTAR was 7.04. The worst score were the item 1 (26 studies didn't provide an ‘a priori’ design), item 4 (10 studies didn't provide whether the status of publication used as an inclusion criterion?), item 10 and item 11 (15 studies didn't assess the likelihood of publication bias and the potential conflicts of interest). The PRISMA score ranged from 17.0 to 24.5. The main problems of reporting were protocol and registration, search, additional analyses and funding.ConclusionThe evidence shows that the reporting and methodological quality of the SRs/MAs of DPP-4 inhibitors for type 2 diabetes are not high.

关键词: DPP-4 抑制剂; 2 型糖尿病; 系统评价再评价; AMSTAR; PRISMA

Key words: Dipeptidyl peptidase-4 inhibitor; Type 2 diabetes mellitus; Overview of systematic review; AMSTAR; PRISMA

引用本文: 令娟, 张定华, 窦莹环, 谢卓霖, 葛龙, 汪永峰, 荀杨芹, 田金徽, 杨克虎. DPP-4 抑制剂治疗 2 型糖尿病的系统评价再评价. 中国循证医学杂志, 2018, 18(2): 208-215. doi: 10.7507/1672-2531.201706017 复制

登录后 ,请手动点击刷新查看全文内容。 没有账号,
登录后 ,请手动点击刷新查看图表内容。 没有账号,
1. International Diabetes Federation. IDF Diabetes Atlas 7th Edition. Available at: https://www.idf.org/our-activities/advocacy-awareness/resources-and-tools/13:diabetes-atlas-seventh-edition.html.
2. Yang WY, Lu JM, Weng JP, et al. Prevalence of diabetes among men and women in China. N Engl J Med, 2010, 362(25): 2425.
3. Holman RR, Paul SK, Bethel MA, et al. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med, 2008, 359(15): 1577-1589.
4. Thornberry NA, Weber AE. Discovery of JANUVIA (Sitagliptin), a selective dipeptidyl peptidase IV inhibitor for the treatment of type 2 diabetes. Curr Top Med Chem, 2007, 7 (6): 557-568.
5. Tahrani AA, Piya MK, Barnett AH. Saxagliptin: a new DPP-4 inhibitor for the treatment of type 2 diabetes mellitus. Adv Ther, 2009, 26(3): 249-262.
6. Eckhardt M, Langkopf E, Mark M, et al. 8-(3-(R)-aminopiperidin-1-yl)-7-but-2-ynyl-3-methyl-1-(4-methyl-quinazolin-2-ylmethyl)-3,7-dihydropurine-2,6-dione (BI 1356), a highly potent, selective, long-acting, and orally bioavailable DPP-4 inhibitor for the treatment of type 2 diabetes. J Med Chem, 2007, 50(26): 6450-6453.
7. Feng J, Zhang ZY, Wallace MB, et al. Discovery of alogliptin: a potent, selective, bioavailable, and efficacious inhibitor of dipeptidyl peptidase IV. J Med Chem, 2007, 50(10): 2297-2300.
8. Shea BJ, Bouter LM, Peterson J, et al. External validation of a measurement tool to assess systematic reviews (AMSTAR). PLoS One, 2007, 2(12): e1350.
9. 熊俊, 陈日新. 系统评价/Meta分析方法学质量的评价工具 AMSTAR. 中国循证医学杂志, 2011, 11(9): 1084-1089.
10. Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. BMJ, 2009, 339(10): e1-e34.
11. Zhou JB, Bai L, Wang Y, et al. The benefits and risks of DPP4-IV-inhibitors vs. sulfonylureas for patients with type 2 diabetes: accumulated evidence from randomised controlled trial. Int J Clin Pract, 2016, 70(2): 132-141.
12. Loh HH, Yee A, Loh HS, et al. Comparative studies of dipeptidyl peptidase 4 inhibitor vs. sulphonylurea among muslim type 2 diabetes patients who fast in the month of ramadan: a systematic review and meta-analysis. Prim Care Diabetes, 2016, 10(3): 210-219.
13. 李军, 唐川, 薛耀明. 胰高血糖素样肽-1 受体激动剂与二肽基肽酶-4 抑制剂治疗 2 型糖尿病的比较研究—系统评价和 Meta 分析. 中国急救医学, 2015, 35(z2): 222-225.
14. Cai X, Han X, Luo Y, et al. Efficacy of dipeptidyl-peptidase-4 inhibitors and impact on beta-cell function in Asian and Caucasian type 2 diabetes mellitus patients: a meta-analysis. J Diabetes, 2015, 7(3): 347-359.
15. 周玥, 何梅, 杨明, 等. GLP-1 受体激动剂与 DPP-4 抑制剂比较治疗 2 型糖尿病效果的系统评价. 中国循证医学杂志, 2014, 14(12): 1459-1466.
16. Zhang Y, Hong J, Chi J, et al. Head-to-head comparison of dipeptidyl peptidase-IV inhibitors and sulfonylureas-a meta-analysis from randomized clinical trials. Diabetes Metab Res Rev, 2014, 30(3): 241-256.
17. Park H, Park C, Kim Y, et al. Efficacy and safety of dipeptidyl peptidase-4 inhibitors in type 2 diabetes: meta-analysis. Ann Pharmacother, 2012, 46(11): 1453-1469.
18. Gooßen K, Gräber S. Longer term safety of dipeptidyl peptidase-4 inhibitors in patients with type 2 diabetes mellitus: systematic review and meta-analysis. Diabetes Obes Metab, 2012, 14(12): 1061-1072.
19. Aroda VR, Henry RR, Han J, et al. Efficacy of GLP-1 receptor agonists and DPP-4 inhibitors: meta-analysis and systematic review. Clin Ther, 2012, 34(6): 1247.
20. Monami M, Iacomelli I, Marchionni N, et al. Dipeptydil [dipeptidyl] peptidase-4 inhibitors in type 2 diabetes: a meta-analysis of randomized clinical trials. Nutr Metab Cardiovasc Dis, 2010, 20(4): 224-235.
21. 徐晓菲, 吴玉波, 吴禹蒙. 西格列汀对 2 型糖尿病患者血脂水平影响的系统评价. 中国药房, 2015, 26(6): 784-787.
22. 李寅辉, 李凯利, 刘浩. 西格列汀治疗 2 型糖尿病药理作用的 Meta 分析. 循证医学, 2015, 15(3): 149-154.
23. Wang T, Gou Z, Wang F, et al. Comparison of GLP-1 analogues versus sitagliptin in the management of type 2 diabetes: systematic review and meta-analysis of head-to-head studies. PLoS One, 2014, 9(8): e103798.
24. 万里燕, 张策, 郭伟宏, 等. 西格列汀治疗 2 型糖尿病疗效和安全性的 Meta 分析. 药物不良反应杂志, 2013, 15(6): 306-313.
25. Du Q, Wu B, Wang YJ, et al. Comparative effects of sitagliptin and metformin in patients with type 2 diabetes mellitus: a meta-analysis. Curr Med Res Opin, 2013, 29(11): 1487-1494.
26. Zhan M, Xu T, Wu F, et al. Sitagliptin in the treatment of type 2 diabetes: a meta-analysis. J Evid Based Med, 2012, 5(3): 154-165.
27. 王瑜, 胡明, 占美, 等. 阿格列汀治疗 2 型糖尿病的系统评价. 中国医院药学杂志, 2014, 34(23): 2014-2022.
28. Berhan A, Berhan Y. Efficacy of alogliptin in type 2 diabetes treatment: a meta-analysis of randomized double-blind controlled studies. BMC Endocr Disord, 2013, 13: 9.
29. Bekiari E, Rizava C, Athanasiadou E, et al. Systematic review and meta-analysis of vildagliptin for treatment of type 2 diabetes. Endocrine, 2016, 52(3): 458-480.
30. 占美, 吴逢波, 黄晶, 等. 维格列汀改善 2 型糖尿病患者 β 细胞功能的 Meta 分析. 中国药房, 2012, 23(6): 555-557.
31. Cai L, Cai Y, Lu ZJ, et al. The efficacy and safety of vildagliptin in patients with type 2 diabetes: a meta-analysis of randomized clinical trials. J Clin Pharm Ther, 2012, 37(4): 386-398.
32. 占美, 吴逢波, 徐珽, 等. 维格列汀与其他口服降糖药对照治疗 2 型糖尿病的 Meta 分析. 中国医院药学杂志, 2011, 31(21): 1824-1828.
33. 臧彦楠, 谢振伟, 方翼. 利格列汀治疗 2 型糖尿病的系统评价. 中国临床药理学与治疗学, 2015, 20(7): 778-787.
34. 杨婷, 路敏, 周颖, 等. 利格列汀治疗 2 型糖尿病安全性的系统评价. 药品评价, 2013, 10(6): 16-20.
35. Yao L, Fan FF, Hu L, et al. Efficacy and safety of saxagliptin in patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled trials. J Chin Pharm Sci, 2016, 25(2): 128-139.
36. 凌雪梅, 杨春霞. 沙格列汀改善 2 型糖尿病患者 β 细胞功能的 Meta 分析. 中国循证医学杂志, 2013, 13(4): 436-440.
37. 占美, 徐珽, 吴逢波, 等. 沙格列汀治疗 2 型糖尿病的 Meta 分析. 中国循证医学杂志, 2012, 12(6): 708-713.