PMID- 30148851
OWN - NLM
STAT- MEDLINE
DCOM- 20190207
LR  - 20221207
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 13
IP  - 8
DP  - 2018
TI  - Comparison of antidiabetic drugs added to sulfonylurea monotherapy in patients 
      with type 2 diabetes mellitus: A network meta-analysis.
PG  - e0202563
LID - 10.1371/journal.pone.0202563 [doi]
LID - e0202563
AB  - AIMS: This study aimed to investigate the efficacy and safety of dual therapy 
      comprising sulfonylurea (SU) plus antidiabetic drugs for the treatment of type 2 
      diabetes mellitus (T2DM). METHODS: We searched the PubMed, Cochrane library, and 
      Embase databases for randomized clinical trials (>/=24 weeks) published up to 
      December 28, 2017. Subsequently, we conducted pairwise and network meta-analyses 
      to calculate the odds ratios (ORs) and mean differences (MDs) with 95% confidence 
      intervals (CIs) of the outcomes. RESULTS: The final analyses included 24 trials 
      with a total of 10,032 patients. Compared with placebo, all treatment regimens 
      were associated with a significantly higher risk of hypoglycemia, except the 
      combinations of SU plus sodium-glucose co-transporter-2 inhibitor (SGLT-2i) [OR, 
      1.35 (95% CI: 0.81 to 2.25)] or alpha-glucosidase inhibitor (AGI) [OR, 1.16 (95% 
      CI: 0.55 to 2.44)]. Notably, the combination of SU plus glucagon-like peptide-1 
      receptor agonist (GLP-1RA) was associated with the most significant increase in 
      the risk of hypoglycemia. Furthermore, all SU-based combination regimens reduced 
      the glycated hemoglobin (HbA1c) and fasting plasma glucose levels (FPG). However, 
      only combinations containing SGLT-2i [MD, -1.00 kg (95% CI: -1.73 to -0.27)] and 
      GLP-1RA [MD, -0.56 kg (95% CI: -1.10 to -0.02)] led to weight loss. CONCLUSIONS: 
      Our findings highlight the importance of considering the risk of hypoglycemia 
      when selecting antidiabetic drugs to be administered concomitantly with SU. 
      Although all classes of antidiabetic drugs improved glucose control when 
      administered in combination with SU, SGLT-2i might be the best option with 
      respect to factors such as hypoglycemia and body weight.
FAU - Qian, Dan
AU  - Qian D
AD  - Department of Pharmacy, The Third Affiliated Hospital of Guangzhou Medical 
      University, Guangzhou, China.
FAU - Zhang, Tiantian
AU  - Zhang T
AD  - College of Pharmacy, Jinan University, Guangzhou, China.
FAU - Tan, Xiangping
AU  - Tan X
AD  - Department of Pharmacy, The Third Affiliated Hospital of Guangzhou Medical 
      University, Guangzhou, China.
FAU - Zheng, Peiying
AU  - Zheng P
AD  - Department of Pharmacy, The Third Affiliated Hospital of Guangzhou Medical 
      University, Guangzhou, China.
FAU - Liang, Zhuoru
AU  - Liang Z
AD  - College of Pharmacy, Jinan University, Guangzhou, China.
FAU - Xie, Jingmei
AU  - Xie J
AD  - College of Pharmacy, Jinan University, Guangzhou, China.
FAU - Jiang, Jie
AU  - Jiang J
AD  - College of Pharmacy, Jinan University, Guangzhou, China.
FAU - Situ, Bing
AU  - Situ B
AUID- ORCID: 0000-0002-1615-1191
AD  - Department of Pharmacy, The Third Affiliated Hospital of Guangzhou Medical 
      University, Guangzhou, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20180827
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Blood Glucose)
RN  - 0 (Dipeptidyl-Peptidase IV Inhibitors)
RN  - 0 (Drug Combinations)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Sulfonylurea Compounds)
RN  - 9100L32L2N (Metformin)
SB  - IM
MH  - Blood Glucose/drug effects
MH  - Body Weight
MH  - Diabetes Mellitus, Type 2/blood/*drug therapy/pathology
MH  - Dipeptidyl-Peptidase IV Inhibitors/therapeutic use
MH  - Drug Combinations
MH  - Female
MH  - Glycated Hemoglobin/drug effects/metabolism
MH  - Humans
MH  - Hypoglycemia/blood/*drug therapy/pathology
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Male
MH  - Metformin/therapeutic use
MH  - Network Meta-Analysis
MH  - Randomized Controlled Trials as Topic
MH  - Sulfonylurea Compounds/*therapeutic use
MH  - Weight Loss/drug effects
PMC - PMC6110472
COIS- The authors have declared that no competing interests exist.
EDAT- 2018/08/28 06:00
MHDA- 2019/02/08 06:00
PMCR- 2018/08/27
CRDT- 2018/08/28 06:00
PHST- 2018/03/12 00:00 [received]
PHST- 2018/08/06 00:00 [accepted]
PHST- 2018/08/28 06:00 [entrez]
PHST- 2018/08/28 06:00 [pubmed]
PHST- 2019/02/08 06:00 [medline]
PHST- 2018/08/27 00:00 [pmc-release]
AID - PONE-D-18-07621 [pii]
AID - 10.1371/journal.pone.0202563 [doi]
PST - epublish
SO  - PLoS One. 2018 Aug 27;13(8):e0202563. doi: 10.1371/journal.pone.0202563. 
      eCollection 2018.