PMID- 26915531
OWN - NLM
STAT- MEDLINE
DCOM- 20170104
LR  - 20170105
IS  - 1525-6049 (Electronic)
IS  - 0886-022X (Linking)
VI  - 38
IP  - 4
DP  - 2016
TI  - The efficacy and safety of dipeptidyl peptidase-4 inhibitors for treatment of 
      type 2 diabetes mellitus patients with severe renal impairment: a meta-analysis.
PG  - 581-7
LID - 10.3109/0886022X.2016.1149682 [doi]
AB  - AIMS/INTRODUCTION: Dipeptidyl peptidase-4 (DPP-4) inhibitors are a new class of 
      oral antidiabetic agents, and have been increasingly and widely used in the 
      treatment of diabetes mellitus (DM). However, information of DPP-4 inhibitors in 
      type 2 DM patients with severe renal impairment (RI) is limited. Our study aimed 
      to assess the efficacy and safety of DPP-4 inhibitors as compared to placebos or 
      other hypoglycemic drugs in type 2 DM patients with severe RI. MATERIALS AND 
      METHODS: A meta-analysis was conducted to examine the literature comparing the 
      effects of DPP-4 inhibitors on hemoglobin A1c (HbA1c) and fasting blood glucose 
      (FBG). Randomized control trials (RCTs) including adults with type 2 DM and 
      severe RI were analyzed. Safety was evaluated based on the percentage of patients 
      who developed hypoglycemia and the occurrence of adverse events (AEs) as well as 
      the incidence of peripheral edema, urinary tract infection, diarrhea, and death. 
      RESULTS: Five RCTs including 503 patients were analyzed. Compared with a placebo 
      or no treatment, DPP-4 inhibitors were associated with a larger decline in HbA1c 
      (mean difference (MD) = -0.57, 95% confidence interval (CI): -0.73 to -0.41; 
      p < 0.01) but not with FBG (MD = -0.26, 95% CI: -1.40 to 0.8; p = 0.66). Compared 
      with glipizide monotherapy, no significant differences in HbA1c (MD = 0.15, 95% 
      CI: -0.19 to 0.49; p = 0.38) or FBG (MD = -0.26, 95% CI: -1.16 to 0.64; p = 0.57) 
      were found. Similar odds of experiencing an AE were found in both the DPP-4 
      inhibitor groups and comparison groups. CONCLUSIONS: In type 2 DM patients with 
      severe RI, treatment with DPP-4 inhibitors is safe and it effectively lowers 
      HbA1c.
FAU - Chen, Maosheng
AU  - Chen M
AD  - a Department of Nephrology , Zhejiang Provincial People's Hospital , Hangzhou , 
      PR China ;
AD  - b National Clinical Research Center of Kidney Diseases , Jinling Hospital, 
      Nanjing University School of Medicine , Nanjing , PR China ;
FAU - Liu, Yueming
AU  - Liu Y
AD  - a Department of Nephrology , Zhejiang Provincial People's Hospital , Hangzhou , 
      PR China ;
FAU - Jin, Juan
AU  - Jin J
AD  - a Department of Nephrology , Zhejiang Provincial People's Hospital , Hangzhou , 
      PR China ;
FAU - He, Qiang
AU  - He Q
AD  - a Department of Nephrology , Zhejiang Provincial People's Hospital , Hangzhou , 
      PR China ;
AD  - c Wenzhou Medical University Wenzhou , Wenzhou , PR China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
DEP - 20160226
PL  - England
TA  - Ren Fail
JT  - Renal failure
JID - 8701128
RN  - 0 (Dipeptidyl-Peptidase IV Inhibitors)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Diabetes Mellitus, Type 2/complications/*drug therapy
MH  - Diabetic Nephropathies/complications
MH  - Dipeptidyl-Peptidase IV Inhibitors/adverse effects/*therapeutic use
MH  - Humans
MH  - Hypoglycemic Agents/adverse effects/*therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - Renal Insufficiency/complications
MH  - Severity of Illness Index
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Dipeptidyl peptidase-4 inhibitors
OT  - meta-analysis
OT  - severe renal impairment
EDAT- 2016/02/27 06:00
MHDA- 2017/01/05 06:00
CRDT- 2016/02/27 06:00
PHST- 2016/02/27 06:00 [entrez]
PHST- 2016/02/27 06:00 [pubmed]
PHST- 2017/01/05 06:00 [medline]
AID - 10.3109/0886022X.2016.1149682 [doi]
PST - ppublish
SO  - Ren Fail. 2016;38(4):581-7. doi: 10.3109/0886022X.2016.1149682. Epub 2016 Feb 26.