The safety of dipeptidyl peptidase‐4 (DPP‐4) inhibitors or sodium‐glucose cotransporter 2 (SGLT‐2) inhibitors added to metformin background therapy in patients with type 2 diabetes mellitus: a systematic review and meta‐analysis

Abstract

The aim of the present meta-analysis was to assess the safety profile of dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium-glucose cotransporter 2 (SGLT-2) inhibitors in comparison with placebo as add-on to metformin therapy in patients with type 2 diabetes. Randomized controlled trials and controlled clinical trials were identified by searching Pubmed, Embase and the Cochrane Central Register of Controlled Trials database until 15 July 2013. All included studies were critically appraised and analysed with the use of Review Manager 5.1.0 software according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement protocol. Twenty randomized and double-blinded studies published in 22 articles fulfilled the inclusion criteria for meta-analysis. The overall results demonstrated that the use of oral antidiabetic agents (analysed separately and together) was not associated with any significantly increased risk of any serious adverse events including hypoglycaemia and gastrointestinal disorders. Moreover, the use of DPP-4 or SGLT-2 inhibitors significantly decreased risk of diarrhoea compared with placebo, when given concomitantly with metformin. However, we found that the SGLT-2 inhibitors were more likely to cause a genital infection. Despite some limitations, the findings of this meta-analysis indicate that DPP-4 or SGLT-2 inhibitors have favourable safety profile, and such therapy, when combined with metformin is well tolerated.

Dipeptidyl peptidase-4 inhibitors and risk of heart failure in type 2 diabetes: systematic review and meta-analysis of randomised and observational studies

“…1 Dipeptidyl peptidase-4 (DPP-4) inhibitors are a relatively new class of incretin based agents for treating type 2 diabetes. Evidence from randomised controlled trials has established that DPP-4 inhibitors reduce levels of glycated haemoglobin (HbA1c), 2 3 do not affect body weight, 2 pose a low risk of hypoglycaemia, 4 and do not increase the risk of cardiovascular events. [5][6][7] The American Diabetes Association and European Association for the Study of Diabetes have recommended this drug class as second line agents for type 2 diabetes management.…”

An Assessment of Anti-hyperglycemic Drug Utilization Patterns and Adherence to AACE/ACE 2015 Guidelines in South Indian Tertiary Care Teaching Hospital

“…There were studies published that use of DPP-4i in both dual and triple therapy is safe and efficacious option. [20][21][22] …”

Managing vascular risk factors among obese quitters with diabetes: how intensive lifestyle intervention and novel pharmacotherapy can work in concert?

“…55 DPP-4 inhibitors, on the other hand, are weightneutral glucose-lowering drugs with a favourable outcome on a number of cardiovascular risk factors including HbA1c and lipid profile. 56 A recent meta-analysis compared GLP-1RAs and DPP-4 inhibitors for their glucose-lowering efficacy and weight-reducing properties. Long-acting GLP-1RAs showed a greater reduction in HbA1c from baseline than DPP-4 inhibitors.…”