目的系统评价瑞格列奈在中国T2DM患者中与其他口服降糖药物相比的相对疗效及安全性。方法在数据库中进行文献检索并设定人选研究标准,对入选研究进行荟萃分析。结果纳入96项研究。在降低HbA1c方面,瑞格列奈优于安慰剂及磺脲类药物(SUs),与α-葡萄糖苷酶抑制剂(AGIs)、那格列奈、二甲双胍、噻唑烷二酮(TZDs)相当;在降低FPG方面,瑞格列奈优于安慰剂、SUs及那格列奈,与AGIs、二甲双胍、TZDs相当;在降低餐后血糖方面,瑞格列奈与那格列奈和TZDs相当,优于安慰剂、AGIs、二甲双胍及SUs。结论本研究更全面地提供了瑞格列奈相对于其他口服降糖药物在中国T2DM患者中与疗效及安全性相关的临床证据。
Objective To evaluate the comparative efficacy and safety of repaglinide against other hypoglycemic agents in Chinese T2DM patients. Methods The MEDLINE, EMBASI and CENTRAL were searched and qualified studies were included. Results Totally 96 qualified studies were included. In terms of HbA1c decline, repaglinide treatment was superior to placebo (WMD: -0. 87%, 95%CI: - 1. 21%- 0. 53) or sulfonylureas (SUs) (WMD : - 0. 23%, 95% CI: -0. 41 - 0. 06), and was comparable with nateglinide, metformin, α-glucosidase inhibitors (AGIs) or TZDs. In terms of fasting glucose lowering, repaglinide treatment was superior to placebo (WMD: -1.50 mmol/L, 95%CI: -1. 95%-1.05), nateglinide (WMD: -0. 17 mmol/L, 95%CI: -0. 30%--0. 05) or SUs (WMD:-0.24 mmol/L, 95%CI: -0. 46%--0. 01), and was comparable with metformin, AGIs or TZDs. In terms of postprandial glucose lowering, repaglinide treatment was superior to placebo, AGIs, metformin or SUs, and was comparable with nateglinide or TZDs. In terms of BMI, repaglinide treatment was superior to SUs. In terms of hypoglycemic rate, repaglinide treatment was superior to SUs, and was comparable with nateglinide. Conclusion This Meta-analysis provides more comprehensive clinical evidence on the comparative efficacy and safety of repaglinide in treating Chinese T2DM patients.