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Effectiveness and safety of glimepiride and iDPP4, associated with metformin in second line pharmacotherapy of type 2 diabetes mellitus: systematic review and meta‐analysis

OBJECTIVE: Our review analyses the studies that have specifically compared the association iDPP4/metformin with glimepiride/metformin, both in second line pharmacotherapy of type 2 diabetes mellitus (DM2). METHODS: Systematic literature review with a meta‐analysis of clinical trials comparing glimep...

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Autores principales: Amate, JM., Lopez‐Cuadrado, T., Almendro, N., Bouza, C., Saz‐Parkinson, Z., Rivas‐Ruiz, R., Gonzalez‐Canudas, J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5024024/
https://www.ncbi.nlm.nih.gov/pubmed/25683794
http://dx.doi.org/10.1111/ijcp.12605
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author Amate, JM.
Lopez‐Cuadrado, T.
Almendro, N.
Bouza, C.
Saz‐Parkinson, Z.
Rivas‐Ruiz, R.
Gonzalez‐Canudas, J.
author_facet Amate, JM.
Lopez‐Cuadrado, T.
Almendro, N.
Bouza, C.
Saz‐Parkinson, Z.
Rivas‐Ruiz, R.
Gonzalez‐Canudas, J.
author_sort Amate, JM.
collection PubMed
description OBJECTIVE: Our review analyses the studies that have specifically compared the association iDPP4/metformin with glimepiride/metformin, both in second line pharmacotherapy of type 2 diabetes mellitus (DM2). METHODS: Systematic literature review with a meta‐analysis of clinical trials comparing glimepiride with any iDPP4, both used together with metformin as a second line treatment of DM2. The effectiveness variables used were as follows: %HbA1c variation, fasting plasma glucose variation, patients achieving the therapeutic objective of HbA1c <7%, treatment dropouts due to lack of effectiveness and rescue treatments needed. The safety variables included were as follows: weight variation at the end of treatment; presentation of any type of adverse event; presentation of serious adverse events; patients who experienced any type of hypoglycaemia; patients who experienced severe hypoglycaemia; treatments suspended due to adverse effects; and deaths for any reason. RESULTS: Four studies met the inclusion criteria. The group treated with glimepiride showed better results in all effectiveness variables. Regarding safety variables, the main differences observed were in the greater number of cases with hypoglycaemia in the group treated with glimepiride, and the serious adverse events or treatment discontinuations due to these which occurred in slightly over 2% more cases in this group compared to the iDPP4 group. The remaining adverse events, including mortality, did not show any differences between both groups. The variation in the weight difference between groups (2.1 kg) is not considered clinically relevant. CONCLUSIONS: A greater effectiveness is seen in the glimepiride/metformin association, which should not be diminished by slight differences in adverse effects, with absence of severe hypoglycaemia in over 98% of patients under treatment. The association of glimepiride/metformin, both due to cost as well as effectiveness and safety, may be the preferential treatment for most DM2 patients, and it offers a potential advantage in refractory hyperglycemic populations, tolerant to treatment.
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spelling pubmed-50240242016-09-23 Effectiveness and safety of glimepiride and iDPP4, associated with metformin in second line pharmacotherapy of type 2 diabetes mellitus: systematic review and meta‐analysis Amate, JM. Lopez‐Cuadrado, T. Almendro, N. Bouza, C. Saz‐Parkinson, Z. Rivas‐Ruiz, R. Gonzalez‐Canudas, J. Int J Clin Pract Endocrinology and Metabolism OBJECTIVE: Our review analyses the studies that have specifically compared the association iDPP4/metformin with glimepiride/metformin, both in second line pharmacotherapy of type 2 diabetes mellitus (DM2). METHODS: Systematic literature review with a meta‐analysis of clinical trials comparing glimepiride with any iDPP4, both used together with metformin as a second line treatment of DM2. The effectiveness variables used were as follows: %HbA1c variation, fasting plasma glucose variation, patients achieving the therapeutic objective of HbA1c <7%, treatment dropouts due to lack of effectiveness and rescue treatments needed. The safety variables included were as follows: weight variation at the end of treatment; presentation of any type of adverse event; presentation of serious adverse events; patients who experienced any type of hypoglycaemia; patients who experienced severe hypoglycaemia; treatments suspended due to adverse effects; and deaths for any reason. RESULTS: Four studies met the inclusion criteria. The group treated with glimepiride showed better results in all effectiveness variables. Regarding safety variables, the main differences observed were in the greater number of cases with hypoglycaemia in the group treated with glimepiride, and the serious adverse events or treatment discontinuations due to these which occurred in slightly over 2% more cases in this group compared to the iDPP4 group. The remaining adverse events, including mortality, did not show any differences between both groups. The variation in the weight difference between groups (2.1 kg) is not considered clinically relevant. CONCLUSIONS: A greater effectiveness is seen in the glimepiride/metformin association, which should not be diminished by slight differences in adverse effects, with absence of severe hypoglycaemia in over 98% of patients under treatment. The association of glimepiride/metformin, both due to cost as well as effectiveness and safety, may be the preferential treatment for most DM2 patients, and it offers a potential advantage in refractory hyperglycemic populations, tolerant to treatment. John Wiley and Sons Inc. 2015-02-16 2015-03 /pmc/articles/PMC5024024/ /pubmed/25683794 http://dx.doi.org/10.1111/ijcp.12605 Text en © 2015 The Authors. International Journal of Clinical Practice Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Endocrinology and Metabolism
Amate, JM.
Lopez‐Cuadrado, T.
Almendro, N.
Bouza, C.
Saz‐Parkinson, Z.
Rivas‐Ruiz, R.
Gonzalez‐Canudas, J.
Effectiveness and safety of glimepiride and iDPP4, associated with metformin in second line pharmacotherapy of type 2 diabetes mellitus: systematic review and meta‐analysis
title Effectiveness and safety of glimepiride and iDPP4, associated with metformin in second line pharmacotherapy of type 2 diabetes mellitus: systematic review and meta‐analysis
title_full Effectiveness and safety of glimepiride and iDPP4, associated with metformin in second line pharmacotherapy of type 2 diabetes mellitus: systematic review and meta‐analysis
title_fullStr Effectiveness and safety of glimepiride and iDPP4, associated with metformin in second line pharmacotherapy of type 2 diabetes mellitus: systematic review and meta‐analysis
title_full_unstemmed Effectiveness and safety of glimepiride and iDPP4, associated with metformin in second line pharmacotherapy of type 2 diabetes mellitus: systematic review and meta‐analysis
title_short Effectiveness and safety of glimepiride and iDPP4, associated with metformin in second line pharmacotherapy of type 2 diabetes mellitus: systematic review and meta‐analysis
title_sort effectiveness and safety of glimepiride and idpp4, associated with metformin in second line pharmacotherapy of type 2 diabetes mellitus: systematic review and meta‐analysis
topic Endocrinology and Metabolism
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5024024/
https://www.ncbi.nlm.nih.gov/pubmed/25683794
http://dx.doi.org/10.1111/ijcp.12605
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