Risk of arthralgia due to dipeptidyl peptidase-4 inhibitors: a Meta-analysis
10.3760/cma.j.issn.1008-5734.2016.04.005
- VernacularTitle:二肽基肽酶-4抑制剂致关节痛风险Meta分析
- Author:
Wenhui HUANG
1
;
Yakun ZHANG
;
Xingyun HOU
;
Xiaofeng LIN
Author Information
1. 解放军第一七五医院药学科, 福建漳州,363000
- Publication Type:Journal Article
- Keywords:
Dipeptidyl-peptidase Ⅳ inhibitors;
Arthralgia;
Meta-analysis
- From:
Adverse Drug Reactions Journal
2016;18(4):261-272
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the risk of arthralgia due to dipeptidyl peptidase-4 (DPP-4) inhibitors.Methods The documents involving arthralgia due to DPP-4 inhibitors ending in February 2016 were searched from correlative data base and online library.DPP-4 inhibitors was used in the test group while placebo was used in the control group.The relevant data were collected from enrolled documents and the quality of RCTs was assessed.The software Review Manager 5.3 was used for Meta-analysis and the results were expressed in RR and 95％ CI.Results A total of 22 RCTs were enrolled into the Meta-analysis and 9 927 patients [6 760 cases in the test group (T) and 3 167 cases in the control group(T)] were treated 12 to 206 weeks.The number of patients who were enrolled into the study on sitagliptin,saxagliptin,vildagliptin,linagliptin,and alogliptin were 954 (T:545,C:409),4 246 (T:2 923,C:1323),899 (T:528,C:371),2 624 (T:1 893,C:731),and 1 204 (T:871,C:333),respectively.The results of quality evaluation to all literatures showed 13 for Grade A and 8 for Grade B.The results of Meta analysis showed that the risk of arthralgia induced by saxagliptin and vildagliptin was higher than that by placebo (RR =1.35,95％ CI:1.01-1.81,P =0.04 and RR =2.80,95％ CI:1.29-6.08,P ＜ 0.01).The results of subgroup analysis showed that the risk of arthralgia induced by saxagliptin 2.5 mg/d added to metformin or TZDs,saxagliptin 10 mg/d monotherapy or added to metformin,and vildagliptin 50 mg/d was higher than that by placebo (RR =1.74,95％ CI:1.06-2.88,P =0.03;RR =1.97,95％CI:1.01-3.82,P =0.05;RR =1.86,95％CI:1.06-3.28,P =0.03;RR =2.55,95％CI:1.15-5.64,P =0.02).The risk of arthralgiadue induced by itagliptin,linagliptin,and alogliptin were similar with that by placebo(all P ＞ 0.05).Conclusions Saxagliptin and vildagliptin may increase the risk of arthralgia.The patients with type 2 diabetes and joint disease should choose sitagliptin,linagliptin or alogliptin when they were using DPP-4 inhibitors.
