Research Papers:
Comparison of twelve single-drug regimens for the treatment of type 2 diabetes mellitus
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Abstract
Shao-Lian Wang1, Wen-Bin Dong2, Xiao-Lin Dong1, Wen-Min Zhu1, Fang-Fang Wang1, Fang Han1 and Xin Yan1
1Department of Endocrinology, Jinan Central Hospital, Jinan 250013, P.R. China
2Pharmaceutical Preparation Section, Jinan Central Hospital, Jinan 250013, P.R. China
Correspondence to:
Xiao-Lin Dong, email: [email protected]
Keywords: type 2 diabetes mellitus, single-drug regimen, effects, randomized controlled trials, network meta-analysis
Received: March 29, 2017 Accepted: July 18, 2017 Published: August 16, 2017
ABSTRACT
We performed a network meta-analysis to compare the efficacy of 12 single-drug regimens (Glibenclamide, Glimepiride, Pioglitazone, Rosiglitazone, Repaglinide, Metformin, Sitaglitin, Exenatide, Liraglutide, Acarbose, Benfluorex, and Glipizide) in the treatment of type 2 diabetes mellitus (T2DM). Fifteen relevant randomized controlled trials (RCTs) were included; direct and indirect evidence from these studies was combined, and weighted mean difference (WMD) and surface under the cumulative ranking curves (SUCRAs) were examined to evaluate the monotherapies. Liraglutide was more effective than Glimepiride, Pioglitazone, Sitaglitin, Exenatide, and Glipizide at reducing glycated hemoglobin (HbA1c) levels. In contrast, Acarbose was less effective than Glibenclamide, Glimepiride, Pioglitazone, Rosiglitazone, Repaglinide, Metformin, and Liraglutide at decreasing HbA1c levels. Reductions in fasting plasma glucose (FPG) levels were similar after all treatments. Rosiglitazone was less effective than Glibenclamide and Repaglinide at reducing total cholesterol (TC) levels. High density lipoprotein (HDL), low density lipoprotein (LDL), and triglyceride levels did not differ after treatment with any of the monotherapies. HbA1c and FPG SUCRA values were highest for Liraglutide, while HbA1c and FPG values were lowest for Acarbose, and TC and LDL values were lowest for Rosiglitazone. These results suggest that Liraglutide may be most effective, and Acarbose least effective, at reducing blood glucose levels, while Glibenclamide, Repaglinide, and Metformin may be most effective, and Rosiglitazone least effective, at reducing lipoidemia, in T2DM patients.
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