Evidence mapPaperPMID 25683794Full record

SynthesisInternational journal of clinical practice2015

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

J M Amate, T Lopez-Cuadrado, N Almendro, C Bouza, Z Saz-Parkinson, R Rivas-Ruiz, J Gonzalez-Canudas

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in International journal of clinical practice, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
  4. Article
  5. Article
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  8. Review
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  11. Review
  12. Sulfonylureas: Scoring beyond START STUDY.Indian journal of endocrinology and metabolism
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

J M AmateInstitute of Health "Carlos III", Healthcare Technologies Assessment Agency, Madrid, Spain.
T Lopez-Cuadrado
N Almendro
C Bouza
Z Saz-Parkinson
R Rivas-Ruiz
J Gonzalez-Canudas
Instituto de Salud Carlos III · ESMexican Social Security Institute · MXHospital Clínico San Carlos · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveOur 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).

methodsSystematic 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.

resultsFour 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.

conclusionsA 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.

Indexed as

Blood GlucoseDiabetes Mellitus, Type 2Dipeptidyl Peptidase 4Drug Therapy, CombinationHumansHypoglycemic AgentsMetforminSulfonylurea CompoundsTreatment OutcomeBlood GlucoseDipeptidyl Peptidase 4DPP4 protein, humanglimepirideHypoglycemic AgentsMetforminSulfonylurea Compounds

Identifiers

PMID25683794
PMCPMC5024024
OpenAlexW2058088102

What Socratic holds

Texttitle and abstract
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.