PMID- 35503625
OWN - NLM
STAT- MEDLINE
DCOM- 20220505
LR  - 20221207
IS  - 2284-0729 (Electronic)
IS  - 1128-3602 (Linking)
VI  - 26
IP  - 8
DP  - 2022 Apr
TI  - Efficacy and safety of combination therapy with vildagliptin and metformin vs. 
      metformin monotherapy for Type 2 Diabetes Mellitus therapy: a meta-analysis.
PG  - 2802-2817
LID - 28611 [pii]
LID - 10.26355/eurrev_202204_28611 [doi]
AB  - OBJECTIVE: The aim is to assess the comparative efficacy and safety of 
      combination therapy with vildagliptin and metformin vs. metformin monotherapy in 
      the treatment of type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: We 
      searched on PubMed, Cochrane Library, Web of Science, and Embase databases for 
      randomized controlled trials (RCTs) of combination therapy with vildagliptin and 
      metformin vs. metformin monotherapy in patients with T2DM published up to 30 
      February 2021. The Cochrane tool and Revman 5.3 software was used to assess the 
      risk of bias and conducted the meta-analysis in the included RCTs. Evidence level 
      was assessed by the Grades of Recommendation, Assessment, Development and 
      Evaluation (GRADE) approach. RESULTS: A total of 11 RCTs and 8533 patients were 
      included. For the efficacy, we found that combination therapy with vildagliptin 
      and metformin (dose of metformin >/=1500mg/d) had a significantly higher reduction 
      in hemoglobin A1c (HbA1c) [mean differences (MD)= -0.59, 95% CI (-0.28, -0.16), 
      p<0.00001] and fasting plasma glucose (FPG) level [MD= -0.82, 95% CI (-1.09, 
      -0.56), p<0.00001] than combination therapy with vildagliptin and metformin (dose 
      of metformin <1500 mg/d). Vildagliptin plus metformin as combination therapy 
      reduced body weight loss ratio [MD=0.22, 95% CI (0.17, 0.27), p<0.00001] when 
      compared with metformin monotherapy. In terms of safety, the vildagliptin plus 
      metformin as combination therapy did not increase risk of total adverse events 
      (AEs) [RR=0.98, 95% CI (0.94,1.02), p=0.29], however there were significant 
      statistical difference and did not increase the risk of diarrhea [RR=0.55, 95% CI 
      (0.40, 0.76), p=0.0003] and Gastrointestinal (GI) disorders [RR=0.72, 95% CI 
      (0.58, 0.91), p=0.006], but significantly increased risk of dizziness [RR=1.41, 
      95% CI (1.06, 1.88), p=0.02] when compared with metformin monotherapy. 
      CONCLUSIONS: Compared with metformin, vildagliptin combined with metformin could 
      significantly reduce FPG, HbA1c and body weight. When the dose of metformin in 
      the combination group of vildagliptin and metformin is >/=1500mg/d, the results 
      showed significant reduction in HbA1c and FPG. In addition, it had no risk of 
      increase in total AEs, diarrhea, and GI disorders, but had significant risk of 
      increase in dizziness. GRADE showed that the quality of evidence had high 
      certainty in FPG and moderate certainty in HbA1c, body weight and all AEs.
FAU - Ding, Y
AU  - Ding Y
AD  - College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 
      Zhejiang, China. caolingyong@163.com.
FAU - Liu, Y
AU  - Liu Y
FAU - Qu, Y
AU  - Qu Y
FAU - Lin, M
AU  - Lin M
FAU - Dong, F
AU  - Dong F
FAU - Li, Y
AU  - Li Y
FAU - Cao, L
AU  - Cao L
FAU - Lin, S
AU  - Lin S
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PL  - Italy
TA  - Eur Rev Med Pharmacol Sci
JT  - European review for medical and pharmacological sciences
JID - 9717360
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Nitriles)
RN  - 0 (Pyrrolidines)
RN  - 9100L32L2N (Metformin)
RN  - I6B4B2U96P (Vildagliptin)
SB  - IM
MH  - Blood Glucose
MH  - Body Weight
MH  - *Diabetes Mellitus, Type 2
MH  - Diarrhea/drug therapy
MH  - Dizziness/chemically induced
MH  - Drug Therapy, Combination
MH  - Glycated Hemoglobin
MH  - Humans
MH  - Hypoglycemic Agents/adverse effects
MH  - *Metformin/adverse effects
MH  - Nitriles/adverse effects
MH  - Pyrrolidines/adverse effects
MH  - Vildagliptin/therapeutic use
EDAT- 2022/05/04 06:00
MHDA- 2022/05/06 06:00
CRDT- 2022/05/03 12:55
PHST- 2022/05/03 12:55 [entrez]
PHST- 2022/05/04 06:00 [pubmed]
PHST- 2022/05/06 06:00 [medline]
AID - 28611 [pii]
AID - 10.26355/eurrev_202204_28611 [doi]
PST - ppublish
SO  - Eur Rev Med Pharmacol Sci. 2022 Apr;26(8):2802-2817. doi: 
      10.26355/eurrev_202204_28611.