Glycaemic control efficacy of oral antidiabetic drugs in treating type 2 diabetes: a protocol for network meta-analysis

INTRODUCTION: Past studies of network meta-analysis focused on evaluating drug combinations in treating type 2 diabetes but not on evaluating antidiabetic drugs in monotherapy. Clinical guidelines (eg, NICE (National Institute of Health and Care Excellence) clinical guidelines 66 and 87) were based only on the findings of individual clinical trials and pairwise meta-analysis in evaluating monotherapy. This study aims to fill this gap of research by conducting a Bayesian network meta-analysis to compare major antidiabetic drugs, including metformin, glimepiride, glyburide, glipizide, repaglinide, nateglinide, sitagliptin, vildagliptin, saxagliptin and SGLT-2 (sodium-glucose transporter-2) inhibitors. METHODS AND ANALYSES: Randomised controlled trials (RCTs) on the drug therapy of type 2 diabetes with outcome measures including glycosylated haemoglobin or fasting blood glucose will be included. The quality of included RTCs will be evaluated according to the Cochrane Collaboration's risk of bias tool. Traditional pairwise meta-analysis and Bayesian network meta-analysis will be conducted to compare the efficacies of antidiabetic drugs. Sensitivity analysis on the sample size of RCTs, meta-regression analysis on the follow-up periods, dosages and baselines of outcome measure, contradiction analysis between pairwise and network meta-analyses, and publication bias analysis, will be performed. ETHICS AND DISSEMINATION: Ethical approval is not required because this study includes no confidential personal data and interventions on the patients. Pairwise and network meta-analyses are based on the published RCT reports of eligible drugs in treating type 2 diabetes. The results of this study will be disseminated by a peer-reviewed publication. PROTOCOL REGISTRATION NUMBER: PROSPERO CRD42014010567.