Evidence map›Paper›PMID 30431561›Full record

SynthesisMedicine2018

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

Ben Wang, Yan Sun, Yiquan Sang, Xuekui Liu, Jun Liang

Open access · goldAbstract readComparative StudyMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 15% 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

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
  5. Article
  6. Article
  7. Article
  8. Review
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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

5 authors at 2 institutions in 1 country.

Ben WangDepartment of Endocrinology and Central Laboratory, Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes.
Yan SunDepartment of Endocrinology and Central Laboratory, Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes.
Yiquan SangDepartment of Endocrinology and Central Laboratory, Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes.
Xuekui LiuDepartment of Endocrinology and Central Laboratory, Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes.
Jun LiangDepartment of Endocrinology and Central Laboratory, Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes.
Nanjing University of Chinese Medicine · CNXuzhou Medical College · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDipeptidyl peptidase-4 (DPP-4) inhibitor and pioglitazone combination therapy have been widely used for patients with inadequate glycemic control on monotherapy. This meta-analysis assessed the efficacy and safety of this combination therapy in patients with type 2 diabetes mellitus (T2DM).

methodsWe searched the MEDLINE, Embase, and Cochrane 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," "dutogliptin, " "linagliptin," "saxagliptin," "sitagliptin," "vildagliptin," "gliptins," "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 A1c (HbA1c) or fasting plasma glucose (FPG) change, total or any other system Adverse Events (AEs). We estimated effect size with random-effects or fixed-effects meta-analysis, I statistic was used to estimate heterogeneity of results.

resultsSeven 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] -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 associated with further reduction in 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.

conclusionsDPP-4 inhibitor and pioglitazone 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 edema AEs. However, additional large-scale, high quality, long-term follow-up clinical trials are necessary to confirm its long-term effectiveness.

Indexed as

Blood GlucoseDiabetes Mellitus, Type 2Dipeptidyl-Peptidase IV InhibitorsDrug Therapy, CombinationFemaleGlycated HemoglobinHumansHypoglycemic AgentsMaleMiddle AgedPioglitazoneRandomized Controlled Trials as TopicThiazolidinedionesTreatment OutcomeBlood GlucoseDipeptidyl-Peptidase IV InhibitorsGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsPioglitazoneThiazolidinediones

Identifiers

PMID30431561
PMCPMC6257459
OpenAlexW2901473939

What Socratic holds

Textmetadata
LicenceCC BY-NC
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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.