A network meta-analysis of the effectiveness and safety of different doses of ertugliflozin in the treatment of type 2 diabetes

Abstract

Objective: To conduct a network meta-analysis to systematically evaluate the efficacy and safety of different doses of ertugliflozin in the treatment of Type 2 diabetes. Methods: The Pubmed, Embase, Cochrane library, CNKI, Wanfang, Weipu, CBM, Web of science and other daTableases were searched by computer from the beginning of the daTablease to 2021. To search for randomized controlled trial of different doses of ertugliflozin in the treatment of type 2 diabetes, to screen the literature according to inclusion and exclusion criteria, to extract data, and to evaluate the quality of the included studies by Cochrane systematic evaluation methods,using RevMan5.3 software and Stata 16.0 versions for analysis. RESULTS: A total of 11 randomized controlled trials (RCTs) were enrolled, including 5713 patients, The results of network meta-analysis showed that ertugliflozin 5,10,15,25 mg were superior to placebo in reducing glycosylated hemoglobin, Only 15 mg was statistically significant(p<0.05),and ertugliflozin 15 mg ranked first in the rank probability chart; 5,10,15 and 25 mg of ertugliflozin could reduce the fasting plasma glucose (FPG) in patients with type 2 diabetes Mellitus (T2D),and all had statistical significance(p<0.05),in the rank probability chart, ertugliflozin 10mg ranks first; Compared with the Placebo Group, ertugliflozin 5,10,15 and 25 mg reduced the weight of the patients, which was statistically significant(p<0.05). Ertugliflozin 10 mg ranked first in the rank probability chart; In the incidence of adverse drug reactions, hypoglycemia and discontinuation due to adverse drug reactions,compared with the placebo group, only 5 mg and 15 mg group had statistical significance(p<0.05), the difference was significant; The incidence of adverse drug reactions in ertugliflozin 15mg group was lower than that in 5mg group and the incidence of hypoglycemia was higher than that in 5mg group;The discontinuation rate of ertugliflozin 5mg group was higher than that in 15mg group,the difference was significant. But limited by the quality of the study, there is publication bias, and the conclusion still needs to be further verified by high-quality studies. Conclusion: The different dose groups of ertugliflozin are effective for the treatment of T2DM. 15 mg of ertugliflozin can significantly improve HbA1c, while the effect of 10 mg on FPG and body weight is more significant. But there are still certain security issues. Due to the limited quality of relevant literature, there is publication bias, and some dose-related literature is less included, and more large-sample, multi-center high-quality literature is still needed for verification.