Comparison of dipeptidyl peptidase-4 inhibitors and pioglitazone combination therapy versus pioglitazone monotherapy in type 2 diabetes: A system review and meta-analysis

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sitagliptin 4 endocrinologydiseasesdrugs
type 2 diabetes mellitus 3 endocrinologydiseases
diabetes mellitus 3 endocrinologydiseases
hyperglycemia 1 endocrinologydiseases
hypoglycemia 3 endocrinologydiseases
pioglitazone 47 endocrinologydiseasesdrugs

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pioglitazone 67 Title: MedicineComparison of dipeptidyl peptidase-4 inhibitors and pioglitazone combination therapy versus pioglitazone monotherapy in type 2 diabetesA system review and meta-analysisBen
pioglitazone 107 MedicineComparison of dipeptidyl peptidase-4 inhibitors and pioglitazone combination therapy versus pioglitazone monotherapy in type 2 diabetesA system review and meta-analysisBen WangYan SunYiquan SangXuekui LiuJun
pioglitazone 756 11/2018Publication date (epub): 11/2018AbstractAbstractBackground:Dipeptidyl peptidase-4 (DPP-4) inhibitor and pioglitazone combination therapy have been widely used for patients with inadequate glycemic control on monotherapy.
pioglitazone 1161 databases. Studies were eligible if they were randomized controlled trials (RCTs) on DPP-4 inhibitor and pioglitazone combination therapy in patients with T2DM through the end of February 2016, using the keywords “alogliptin,”
pioglitazone 1430 “saxagliptin,” “sitagliptin,” “vildagliptin,” “gliptins,” “DPP-4 inhibitor,” and “ pioglitazone .” RCTs were selected if they compared DPP-4 inhibitors and pioglitazone as combination therapy; treatment
pioglitazone 1504 “DPP-4 inhibitor,” and “pioglitazone.” RCTs were selected if they compared DPP-4 inhibitors and pioglitazone as combination therapy; treatment duration was ≥12 weeks; and the reported data included hemoglobin
pioglitazone 1903 statistic was used to estimate heterogeneity of results.Results:Seven RCTs were included. Compared with pioglitazone monotherapy, combination DPP-4 inhibitor and pioglitazone therapy were associated with increased reduction
pioglitazone 1961 results.Results:Seven RCTs were included. Compared with pioglitazone monotherapy, combination DPP-4 inhibitor and pioglitazone therapy were associated with increased reduction in HbA1c ([MD]-0.64%;−0.73 to −0.55) and FPG ([MD]
pioglitazone 2170 FPG ([MD] −0.94; −1.12 to −0.76) levels, more patients in the combination therapy groups versus pioglitazone monotherapy groups had an A1c of < 7% ([OR]2.52; 2.18, 3.17) at the end of the studies, but was not
pioglitazone 2423 higher risk of hypoglycaemia, edema, or any other system AEs. We also noticed that DPP-4 inhibitor and pioglitazone combination therapy were associated with better improvement of pancreatic β-cell function.Conclusions:DPP-4
pioglitazone 2559 were associated with better improvement of pancreatic β-cell function.Conclusions:DPP-4 inhibitor and pioglitazone combination therapy provided better glycemic control, both according to HbA1c and FPG levels, than pioglitazone
pioglitazone 2671 combination therapy provided better glycemic control, both according to HbA1c and FPG levels, than pioglitazone monotherapy. Safety analysis showed well tolerance of combination therapy, even in hypoglycemic and
pioglitazone 3670 anti-hyperglycemic agents is considered a valid treatment option for these cases.A classic hypoglycemic agent, pioglitazone , is an insulin sensitizer that can activate peroxisome proliferator-activated receptors in order to
pioglitazone 3876 order to increase peripheral glucose uptake and improve insulin resistance. The beneficial effects of pioglitazone on β-cell function have been shown in rodent and cell culture studies. Dipeptidyl peptidase (DPP)-4
pioglitazone 4601 cell culture studies. Given these complementary mechanisms, the combination of DPP-4 inhibitors with pioglitazone has been proposed to be a valid treatment for T2DM.[[7]–[9]] Indeed, glycemic control was attained
pioglitazone 5040 present study assessed the efficacy and safety of initial combination therapy with DPP-4 inhibitors and pioglitazone in patients with T2DM. The main objective of this meta-analysis was to assess the efficacy and safety
pioglitazone 5195 of this meta-analysis was to assess the efficacy and safety of this combination therapy compared to pioglitazone monotherapy for the management of patients with T2DM. The outcome measures included glycemic control,
pioglitazone 5980 this is the first meta-analysis to comparison the effects of dipeptidyl peptidase-4 inhibitors and pioglitazone combination therapy versus pioglitazone monotherapy in type 2 diabetes based on RCTs.Methods2Search
pioglitazone 6020 comparison the effects of dipeptidyl peptidase-4 inhibitors and pioglitazone combination therapy versus pioglitazone monotherapy in type 2 diabetes based on RCTs.Methods2Search strategy and selection criteria2.1The meta-analysis
pioglitazone 6650 The main search term was a combination of MESH terms and text words for “DPP-4 inhibitors” and “ pioglitazone ,” in addition to restricting the study type to “Randomized Controlled Trial,” “RCT,” or “random.”
pioglitazone 7344 ≥12 weeks, which enrolled patients with T2DM with HbA1c levels >7%, and analyzed the efficacy of pioglitazone and DPP-4 inhibitor therapy or placebo by comparing changes in HbA1c levels or during the intervention.We
pioglitazone 7601 meta-analysis of randomized clinical trials (RCTs) in order to compare combination DPP-4 inhibitors and pioglitazone therapy versus pioglitazone monotherapy for the management of T2DM. The primary outcome measures included
pioglitazone 7629 clinical trials (RCTs) in order to compare combination DPP-4 inhibitors and pioglitazone therapy versus pioglitazone monotherapy for the management of T2DM. The primary outcome measures included changes in HbA1c and fasting
pioglitazone 9712 respiratory AEs, digestive tract AEs, nervous systemic AEs, total AEs,). Combination therapy was defined as pioglitazone (30 mg) and the maximum licensed dose of DPP-4 inhibitors. We choose the recommended starting dose;
pioglitazone 12079 HbA1c values at baseline ranged from 7.89% to 9.5% and 7.92% to 9.5% for the combination groups and pioglitazone monotherapy groups, respectively. The mean body mass indexes ranged from 26.07 to 33.1 kg/m2 in the
pioglitazone 12245 indexes ranged from 26.07 to 33.1 kg/m2 in the combination groups and 26.4 to 33.2 kg/m2 in the pioglitazone groups. Three RCTs were performed on drug-naive patients.[[17]–[19]] Four types of gliptins were included,
pioglitazone 12413 patients.[[17]–[19]] Four types of gliptins were included, and the recommended dosage for each medicine ( pioglitazone , 30 mg; sitagliptin, 100 mg; vildagliptin, 100 mg; alogliptin, 25 mg; and linagliptin, 5 mg)
pioglitazone 12834 differences in the baseline characteristics of participants between the combination therapy groups and pioglitazone groups. All 7 trials described random sequence generation and allocation concealment, reported clinically
pioglitazone 13769 reported FPG levels. Analysis of these data revealed that the combination therapy of DPP-4 inhibitor and pioglitazone led to a greater reduction in FPG level (mean difference [MD] −0.94; −1.12 to −0.76) without significant
pioglitazone 15777 change in HOMA-β. HOMA = homeostatic model assessment.Combination therapy with DPP-4 inhibitors and pioglitazone were generally well tolerated over the 12 to 54 week treatment period. There were no differences in
pioglitazone 15948 treatment period. There were no differences in AEs between combination therapy with DPP-4 inhibitors and pioglitazone and pioglitazone in any of the 7 RCTs (Fig. 6A). There were also no differences in reported hypoglycaemia
pioglitazone 15965 There were no differences in AEs between combination therapy with DPP-4 inhibitors and pioglitazone and pioglitazone in any of the 7 RCTs (Fig. 6A). There were also no differences in reported hypoglycaemia between these
pioglitazone 16259 digestive system adverse events with combination therapy was not significantly different from that of pioglitazone monotherapy (RR 0.85, 95% CI 0.54–1.34, P = .98, Fig. 6C).No difference in the incidence of edema,
pioglitazone 16691 of AEs.Figure 6(A) Meta-analyses of total adverse events in patients with combination therapy versus pioglitazone . (B) Meta-analyses of hypoglycemia events in patients with combination therapy versus pioglitazone.
pioglitazone 16790 pioglitazone. (B) Meta-analyses of hypoglycemia events in patients with combination therapy versus pioglitazone . (C) Meta-analyses of digestive system adverse events in patients with combination therapy versus pioglitazone.
pioglitazone 16901 pioglitazone. (C) Meta-analyses of digestive system adverse events in patients with combination therapy versus pioglitazone . (D) Meta-analyses of edema events in patients with combination therapy versus pioglitazone. (E) Meta-analyses
pioglitazone 16993 versus pioglitazone. (D) Meta-analyses of edema events in patients with combination therapy versus pioglitazone . (E) Meta-analyses of respiratory system adverse events in patients with combination therapy vs pioglitazone.
pioglitazone 17102 pioglitazone. (E) Meta-analyses of respiratory system adverse events in patients with combination therapy vs pioglitazone . (F) Meta-analyses of nervous system events in patients with combination therapy versus pioglitazone.Discussion4DPP-4
pioglitazone 17203 pioglitazone. (F) Meta-analyses of nervous system events in patients with combination therapy versus pioglitazone .Discussion4DPP-4 inhibitors combined with pioglitazone, administered once daily, produced significant,
pioglitazone 17258 in patients with combination therapy versus pioglitazone.Discussion4DPP-4 inhibitors combined with pioglitazone , administered once daily, produced significant, clinically meaningful, and sustained improvement in
pioglitazone 17416 significant, clinically meaningful, and sustained improvement in glycemic control from baseline compared with pioglitazone monotherapy. Overall, combination therapy was associated with a 0.61% reduction in HbA1c, as well as
pioglitazone 17797 Additional reduction in FPG level ([MD]-0.94; −1.12 to −0.76) was also documented.Compared with pioglitazone monotherapy, combination therapy did not increase the incidence of AEs. DPP4-inhibtors are generally
pioglitazone 18051 AEs being similar to placebo and a low frequency of hypoglycemia. In our meta-analysis, when added to pioglitazone therapy, similar hypoglycemia risk occurred.[[13],[14],[16],[18]] In addition, the use of thiazolidinediones
pioglitazone 18540 inhibitors remain controversial.[[21]] One original RCT of our meta-analysis which focused on alogliptin and pioglitazone combination therapy, reported this AE.[[15]] None significant difference was revealed between groups.
pioglitazone 21678 on monotherapy. These results were consistent with original RCTs. In addition, DPP-4 inhibitors and pioglitazone combination therapy might be considered as a more favorable option for T2DM patients with dislipdemia
pioglitazone 21847 favorable option for T2DM patients with dislipdemia and insulin resistance.Conclusion5DPP-4 inhibitor and pioglitazone combination therapy provided better glycemic control, both according to HbA1c and FPG levels, than pioglitazone
pioglitazone 21959 combination therapy provided better glycemic control, both according to HbA1c and FPG levels, than pioglitazone monotherapy. Safety analysis showed well tolerance of combination therapy, even in hypoglycemic and
sitagliptin 1348 2016, using the keywords “alogliptin,” “dutogliptin, ” “linagliptin,” “saxagliptin,” “ sitagliptin ,” “vildagliptin,” “gliptins,” “DPP-4 inhibitor,” and “pioglitazone.” RCTs were selected
sitagliptin 4336 inhibiting glucagon secretion, and slowing gastric emptying. Similarly, several DPP-4 inhibitors, such as sitagliptin , have been shown to improve pancreatic β-cell function,[[4]–[6]] with antiapoptotic and pro-proliferative
sitagliptin 11828 and were designed as multicentral studies lasting for 12 to 54 weeks. The DPP-4 inhibitors included sitagliptin ,[[14],[18]] alogliptin,[[15],[16],[19]] vildagliptin,[[17]] and linagliptin.[[13]] The baseline data
sitagliptin 12436 types of gliptins were included, and the recommended dosage for each medicine (pioglitazone, 30 mg; sitagliptin , 100 mg; vildagliptin, 100 mg; alogliptin, 25 mg; and linagliptin, 5 mg) was chosen to avoid
Select Disease Character Offset Disease Term Instance
diabetes mellitus 977 meta-analysis assessed the efficacy and safety of this combination therapy in patients with type 2 diabetes mellitus (T2DM).Methods:We searched the MEDLINE, Embase, and Cochrane databases. Studies were eligible if they
diabetes mellitus 2988 necessary to confirm its long-term effectiveness.Introduction1Diabetes is a worldwide disease, and type 2 diabetes mellitus (T2DM) accounts for more than 90% diabetes cases. It is estimated that approximately 415 million people
diabetes mellitus 18201 occurred.[[13],[14],[16],[18]] In addition, the use of thiazolidinediones in the management of type 2 diabetes mellitus has been associated with an increased risk of fluid retention and edema.[[20]] However, in our meta-analysis,
hyperglycemia 3429 to the progressive nature of this disease, many patients, especially those with moderate-to-severe hyperglycemia , are unlikely to attain hemoglobin A1c (HbA1c) targets <7% with monotherapy.[[2],[3]] Combination therapy
hypoglycemia 16726 total adverse events in patients with combination therapy versus pioglitazone. (B) Meta-analyses of hypoglycemia events in patients with combination therapy versus pioglitazone. (C) Meta-analyses of digestive system
hypoglycemia 18001 generally well tolerated, with the frequency of AEs being similar to placebo and a low frequency of hypoglycemia . In our meta-analysis, when added to pioglitazone therapy, similar hypoglycemia risk occurred.[[13],[14],[16],[18]]
hypoglycemia 18081 a low frequency of hypoglycemia. In our meta-analysis, when added to pioglitazone therapy, similar hypoglycemia risk occurred.[[13],[14],[16],[18]] In addition, the use of thiazolidinediones in the management of
type 2 diabetes mellitus 970 monotherapy. This meta-analysis assessed the efficacy and safety of this combination therapy in patients with type 2 diabetes mellitus (T2DM).Methods:We searched the MEDLINE, Embase, and Cochrane databases. Studies were eligible if they
type 2 diabetes mellitus 2981 necessary to confirm its long-term effectiveness.Introduction1Diabetes is a worldwide disease, and type 2 diabetes mellitus (T2DM) accounts for more than 90% diabetes cases. It is estimated that approximately 415 million people
type 2 diabetes mellitus 18194 risk occurred.[[13],[14],[16],[18]] In addition, the use of thiazolidinediones in the management of type 2 diabetes mellitus has been associated with an increased risk of fluid retention and edema.[[20]] However, in our meta-analysis,

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