PMID- 34544199
OWN - NLM
STAT- MEDLINE
DCOM- 20220317
LR  - 20221207
IS  - 1365-2710 (Electronic)
IS  - 0269-4727 (Linking)
VI  - 47
IP  - 3
DP  - 2022 Mar
TI  - Efficacy and safety of empagliflozin at different doses in patients with type 2 
      diabetes mellitus: A network meta-analysis based on randomized controlled trials.
PG  - 270-286
LID - 10.1111/jcpt.13521 [doi]
AB  - WHAT IS KNOWN AND OBJECTIVE: As an oral hypoglycaemic drug that significantly 
      reduces cardiovascular risk, empagliflozin is often used in patients with type 2 
      diabetes mellitus (T2DM). However, the dosage and administration of empagliflozin 
      are still controversial clinically. To determine the most appropriate dose, we 
      performed this network meta-analysis. METHODS: We identified randomized 
      controlled trials (RCTs) about empagliflozin from eight databases. We analysed 
      the pharmacodynamics, adverse effects (AEs), and pharmacokinetics of 
      empagliflozin at different doses. RESULTS: We identified 8264 articles, of which 
      23 RCTs with 10518 patients were included. Regarding haemoglobin A1c (HbA1c) and 
      fasting plasma glucose (FPG), high-daily doses (10, 25, 50 mg) were significantly 
      better than low doses (1, 2.5, 5 mg). For total AEs, there was a dose-response 
      trend in which safety decreased with increasing doses. According to SUCRA 
      sequencing, the order for lowering HbA1c was 25 > 50 > 10 > 5 > 1 mg, for 
      lowering FPG was 50 > 25 > 10 > 5 > 2.5 > 1 mg and for safety was 1> 5 > 10 > 25> 
      2.5 > 50 mg. When considering HbA1c, FPG and total AEs, we performed a 
      hierarchical cluster analysis and network meta-analysis to find that 25 mg 
      performed best among different doses, which was more significant after long-term 
      use (>/= 12 weeks). Pharmacokinetic parameters exhibited significant dose-response 
      relationships. WHAT IS NEW AND CONCLUSION: High-daily doses (10, 25, 50 mg) had 
      better efficacy than low doses (1, 2.5, 5 mg). When considering HbA1c, FPG and 
      total AEs, 25 mg performed best among the different doses in patients with T2DM.
CI  - (c) 2021 John Wiley & Sons Ltd.
FAU - Wu, Qian
AU  - Wu Q
AD  - Department of Endocrinology, The second affiliated hospital of Nanchang 
      University, Nanchang, China.
AD  - Jiangxi Medical College, Nanchang University, Nanchang, China.
FAU - Liu, Miaowen
AU  - Liu M
AD  - Department of Endocrinology, The second affiliated hospital of Nanchang 
      University, Nanchang, China.
AD  - Jiangxi Medical College, Nanchang University, Nanchang, China.
FAU - Fang, Zige
AU  - Fang Z
AUID- ORCID: 0000-0002-1925-3935
AD  - Department of Endocrinology, The second affiliated hospital of Nanchang 
      University, Nanchang, China.
AD  - Jiangxi Medical College, Nanchang University, Nanchang, China.
FAU - Li, Chenxi
AU  - Li C
AD  - Department of Endocrinology, The second affiliated hospital of Nanchang 
      University, Nanchang, China.
AD  - Jiangxi Medical College, Nanchang University, Nanchang, China.
FAU - Zou, Fang
AU  - Zou F
AD  - Department of Endocrinology, The second affiliated hospital of Nanchang 
      University, Nanchang, China.
FAU - Hu, Lei
AU  - Hu L
AD  - Department of Endocrinology, The second affiliated hospital of Nanchang 
      University, Nanchang, China.
FAU - Zhang, Wenxiong
AU  - Zhang W
AUID- ORCID: 0000-0003-2962-0847
AD  - Department of Cardio-Thoracic Surgery, The second affiliated hospital of Nanchang 
      University, Nanchang, China.
LA  - eng
GR  - 20181BAB215027/Natural Science Foundation of Jiangxi Province/
GR  - 81560345/National Natural Science Foundation of China/
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20210920
PL  - England
TA  - J Clin Pharm Ther
JT  - Journal of clinical pharmacy and therapeutics
JID - 8704308
RN  - 0 (Benzhydryl Compounds)
RN  - 0 (Blood Glucose)
RN  - 0 (Glucosides)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - HDC1R2M35U (empagliflozin)
SB  - IM
MH  - Benzhydryl Compounds
MH  - Blood Glucose
MH  - *Diabetes Mellitus, Type 2/drug therapy
MH  - Double-Blind Method
MH  - Glucosides
MH  - Glycated Hemoglobin/analysis
MH  - Humans
MH  - *Hypoglycemic Agents/adverse effects
MH  - Network Meta-Analysis
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
OTO - NOTNLM
OT  - diabetes
OT  - doses
OT  - empagliflozin
OT  - network meta-analysis
EDAT- 2021/09/21 06:00
MHDA- 2022/03/18 06:00
CRDT- 2021/09/20 20:33
PHST- 2021/08/07 00:00 [revised]
PHST- 2021/06/29 00:00 [received]
PHST- 2021/08/17 00:00 [accepted]
PHST- 2021/09/21 06:00 [pubmed]
PHST- 2022/03/18 06:00 [medline]
PHST- 2021/09/20 20:33 [entrez]
AID - 10.1111/jcpt.13521 [doi]
PST - ppublish
SO  - J Clin Pharm Ther. 2022 Mar;47(3):270-286. doi: 10.1111/jcpt.13521. Epub 2021 Sep 
      20.