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Reporting and methodological quality of systematic reviews of DPP-4 inhibitors for patients with type 2 diabetes mellitus: an evidence-based mapping

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Abstract

Aims

To evaluate the reporting and methodological quality of relevant systematic reviews (SRs) and meta-analyses (MAs) on Dipeptidyl peptidase-4 inhibitors (DPP-4I) for Type 2 diabetes mellitus (T2DM).

Methods

Relevant SRs and MAs on T2DM and DPP-4I published between 2017 and November 2021 were retrieved from PubMed, Embase, Cochrane Library, Web of Science, VIP, CNKI, CBM, and WanFang databases. Two independent reviewers performed the search, selection, and data extraction. The reporting and methodological quality of the reviewers was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR 2) tools. The relationship between reporting and methodological quality score was assessed with the Spearman correlation test.

Results

Twenty-one studies involving 151,715 participants were included in the study. This overview showed that DPP-4I was safer and more efficacious than other anti-hyperglycemic drugs (OADs) in treating T2DM. The methodological quality of one SR was low, while the rest were very low. Thus, refinements are needed in the quality of protocol and registration information, a complete search strategy, the summary of the evidence, the listing of excluded studies, assessing the potential impact of risk of bias in RCTs, and discussing the RoB on MA results, and the funding of RCTs need improvement for generating SR. In addition, the reporting and methodological quality scores were moderately correlated (rS = 0.66, P = 0.001).

Conclusions

DPP-4I is safer and more efficacious than OADs in treating T2DM. However, the reporting and methodological quality of the related SRs was unsatisfactory. Therefore, PRISMA and AMSTAR 2 analyses should be followed to enhance the overall quality of future SRs.

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References

  1. Cloete L (2022) Diabetes mellitus: an overview of the types, symptoms, complications and management. Nurs Stand 37(1):61–66. https://doi.org/10.7748/ns.2021.e11709

    Article  PubMed  Google Scholar 

  2. American Diabetes Association (2021) Classification and diagnosis of diabetes: standards of medical care in diabetes-2021. Diabetes Care 44:S15–S33. https://doi.org/10.2337/dc21-S002

    Article  Google Scholar 

  3. Group National Diabetes Data (1979) Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes Care 28(12):1039–1057. https://doi.org/10.2337/diab.28.12.1039

    Article  Google Scholar 

  4. Gabir MM, Hanson RL, Dabelea D et al (2000) The 1997 American diabetes association and 1999 world health organization criteria for hyperglycemia in the diagnosis and prediction of diabetes. Diabetes Care 23(8):1108–1112. https://doi.org/10.2337/diacare.23.8.1108

    Article  CAS  PubMed  Google Scholar 

  5. International Diabetes Federation. IDF Diabetes Atlas 10th Edition 2021. https://www.idf.org/aboutdiabetes/type-2-diabetes.html

  6. Federation International Diabetes https://diabetesatlas.org/

  7. Drugs for type 2 diabetes (2019) Med Lett. Drugs Ther 61:169–178

    Google Scholar 

  8. Deacon CF (2020) Dipeptidyl peptidase 4 inhibitors in the treatment of type 2 diabetes mellitus. Nat Rev Endocrinol 16(11):642–653. https://doi.org/10.1038/s41574-020-0399-8

    Article  CAS  PubMed  Google Scholar 

  9. Gallwitz B (2019) Clinical use of DPP-4 inhibitors. Front Endocrinol (Lausanne) 10:389. https://doi.org/10.3389/fendo.2019.00389

    Article  Google Scholar 

  10. Bergenstal Richard M, Carol W, Leigh MacConell et al (2010) Efficacy and safety of exenatide once weekly versus sitagliptin or pioglitazone as an adjunct to metformin for treatment of type 2 diabetes (DURATION-2): a randomised trial. The Lancet 376(9739):431–439. https://doi.org/10.1016/s0140-6736(10)60590-9

    Article  CAS  Google Scholar 

  11. Suzuki R, Eiki JI, Moritoyo T et al (2018) Effect of short-term treatment with sitagliptin or glibenclamide on daily glucose fluctuation in drug-naïve Japanese patients with type 2 diabetes mellitus. Diabetes Obes Metab 20(9):2274–2281. https://doi.org/10.1111/dom.13364

    Article  CAS  PubMed  Google Scholar 

  12. Le JT, Qureshi R, Twose C et al (2019) Evaluation of systematic reviews of interventions for retina and vitreous conditions. JAMA Ophthalmol 137(12):1399–1405. https://doi.org/10.1001/jamaophthalmol.2019.4016

    Article  PubMed  PubMed Central  Google Scholar 

  13. Murad MH, Montori VM, Ioannidis JP et al (2014) How to read a systematic review and meta-analysis and apply the results to patient care: users’ guides to the medical literature. JAMA 312(2):171–179. https://doi.org/10.1001/jama.2014.5559

    Article  CAS  PubMed  Google Scholar 

  14. Chen K, Kang D, Yu M et al (2018) Direct head-to-head comparison of glycaemic durability of dipeptidyl peptidase-4 inhibitors and sulphonylureas in patients with type 2 diabetes mellitus: a meta-analysis of long-term randomized controlled trials. Diabetes Obes Metab 20(4):1029–1033. https://doi.org/10.1111/dom.13147

    Article  CAS  PubMed  Google Scholar 

  15. Sharma M, Beckley N, Nazareth I et al (2017) Effectiveness of sitagliptin compared to sulfonylureas for type 2 diabetes mellitus inadequately controlled on metformin: a systematic review and meta-analysis. BMJ Open 7(10):e017260. https://doi.org/10.1136/bmjopen-2017-017260

    Article  PubMed  PubMed Central  Google Scholar 

  16. Hetrick SE, Parker AG, Callahan P et al (2010) Evidence mapping: illustrating an emerging methodology to improve evidence-based practice in youth mental health. J Eval Clin Pract 16(6):1025–1030. https://doi.org/10.1111/j.1365-2753.2008.01112.x

    Article  PubMed  Google Scholar 

  17. Madera Anaya M, Franco JVA, Ballesteros M et al (2019) Evidence mapping and quality assessment of systematic reviews on therapeutic interventions for oral cancer. Cancer Manag Res 11:117–130. https://doi.org/10.2147/CMAR.S186700

    Article  PubMed  Google Scholar 

  18. Liberati A, Altman DG, Tetzlaff J et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339:b2700. https://doi.org/10.1136/bmj.b2700

    Article  PubMed  PubMed Central  Google Scholar 

  19. Shea BJ, Reeves BC, Wells G et al (2017) AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ 358:j4008. https://doi.org/10.1136/bmj.j4008

    Article  PubMed  PubMed Central  Google Scholar 

  20. Lu C, Ke L, Li J et al (2021) Saffron (Crocus sativus L.) and health outcomes: a meta-research review of meta-analyses and an evidence mapping study. Phytomedicine 91:153699. https://doi.org/10.1016/j.phymed.2021.153699

    Article  PubMed  Google Scholar 

  21. Chen J, Wang H, Lu X et al (2021) Safety and efficacy of stem cell therapy: an overview protocol on published meta-analyses and evidence mapping. Ann Transl Med 9(3):270. https://doi.org/10.21037/atm-20-6892

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Cai Y, Zeng T, Wen Z et al (2018) Ethnic differences in efficacy and safety of alogliptin: a systematic review and meta-analysis. Diabetes Ther 9(1):177–191. https://doi.org/10.1007/s13300-017-0352-6

    Article  CAS  PubMed  Google Scholar 

  23. Duan XY, Feng BM, Zhang CB et al (2017) Alogliptin compared with other oral hyperglycemic agents for type 2 diabetes: a systematic review. Chin J New Drugs Clin Rem 36(4):226–233. https://doi.org/10.14109/j.cnki.xyylc.2017.04.009

    Article  Google Scholar 

  24. Dutta D, Agarwal A, Maisnam I et al (2021) Efficacy and safety of the novel dipeptidyl peptidase-4 inhibitor gemigliptin in the management of type 2 diabetes: a meta-analysis. Endocrinol Metab (Seoul) 36(2):374–387. https://doi.org/10.3803/EnM.2020.818

    Article  CAS  Google Scholar 

  25. Farah D, Leme GM, Eliaschewitz FG et al (2019) A safety and tolerability profile comparison between dipeptidyl peptidase-4 inhibitors and sulfonylureas in diabetic patients: a systematic review and meta-analysis. Diabetes Res Clin Pract 149:47–63. https://doi.org/10.1016/j.diabres.2019.01.025

    Article  CAS  PubMed  Google Scholar 

  26. Fujita K, Kaneko M, Narukawa M (2017) Factors related to the glucose-lowering efficacy of dipeptidyl peptidase-4 inhibitors: a systematic review and meta-analysis focusing on ethnicity and study regions. Clin Drug Investig 37(3):219–232. https://doi.org/10.1007/s40261-016-0478-8

    Article  CAS  PubMed  Google Scholar 

  27. Gao Q, Zhang WJ, Jun HW (2019) Comparison of efficacy and safety of dipeptidyl peptidase-4 inhibitors and α-glucosidase inhibitors for treatment of type-2 diabetes mellitus: a meta-analysis. Zhejiang Med J 41(1):47–51. https://doi.org/10.12056/j.issn.1006-2785.2019.41.1.2017-2724

    Article  Google Scholar 

  28. Ito Y, Ambe K, Kobayashi M et al (2017) Ethnic difference in the pharmacodynamics-efficacy relationship of dipeptidyl peptidase-4 inhibitors between Japanese and non-Japanese patients: a systematic review. Clin Pharmacol Ther 102(4):701–708. https://doi.org/10.1002/cpt.692

    Article  CAS  PubMed  Google Scholar 

  29. Lee S, Lee H, Kim Y et al (2019) Effect of DPP-IV inhibitors on glycemic variability in patients with T2DM: a systematic review and meta-analysis. Sci Rep 9(1):13296. https://doi.org/10.1038/s41598-019-49803-9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Li Z, Zhao L, Yu L et al (2019) Head-to-Head comparison of the hypoglycemic efficacy and safety between dipeptidyl peptidase-4 inhibitors and alpha-glucosidase inhibitors in patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled trials. Front Pharmacol 10:777. https://doi.org/10.3389/fphar.2019.00777

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Liu Y, Pu YF, Yang X (2017) The meta-analysis of comparison of curative effect of vildagliptin and acarbose in treatment of elderly patients with type 2 diabetes mellitus. Sichuan Med J 38(5):521–524

    CAS  Google Scholar 

  32. Lyu X, Zhu X, Zhao B et al (2017) Effects of dipeptidyl peptidase-4 inhibitors on beta-cell function and insulin resistance in type 2 diabetes: meta-analysis of randomized controlled trials. Sci Rep 7:44865. https://doi.org/10.1038/srep44865

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Men P, Li XT, Tang HL et al (2018) Efficacy and safety of saxagliptin in patients with type 2 diabetes: a systematic review and meta-analysis. PLoS ONE 13(5):e0197321. https://doi.org/10.1371/journal.pone.0197321

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Oh H, Nguyen HD, Yoon IM et al (2021) Efficacy and tolerability of evogliptin in patients with type 2 diabetes mellitus: a systematic review and meta-analysis with bayesian inference through a quality-management system. Clin Ther 43(8):1336–1355. https://doi.org/10.1016/j.clinthera.2021.06.001

    Article  CAS  PubMed  Google Scholar 

  35. Shibuki K, Shimada S, Aoyama T (2020) Meta-analysis of 11 heterogeneous studies regarding dipeptidyl peptidase 4 inhibitor add-on therapy for type 2 diabetes mellitus patients treated with insulin. J Diabetes Res. https://doi.org/10.1155/2020/6321826

    Article  PubMed  PubMed Central  Google Scholar 

  36. Stoimenis D, Karagiannis T, Katsoula A et al (2017) Once-weekly dipeptidyl peptidase-4 inhibitors for type 2 diabetes: a systematic review and meta-analysis. Expert Opin Pharmacother 18(9):843–851. https://doi.org/10.1080/14656566.2017.1324848

    Article  CAS  PubMed  Google Scholar 

  37. Wen EH, Li Y, Wei SJ et al (2019) Effect of saxagliptin on the HOMA-2 model and blood lipids of patients with type 2 diabetes: a meta- analysis. Chin J Pharmacoepidemiol 28(11):711–716

    CAS  Google Scholar 

  38. Xie XX, Zhang CY, Fan L (2020) Systematic review of omarigliptin in treatment of type 2 diabetes mellitus. Chin J New Drugs Clin Remedies 39(03):181–185. https://doi.org/10.14109/j.cnki.xyylc.2020.03.11

    Article  CAS  Google Scholar 

  39. Yu YQ, Hu PL, Chen J (2018) System evaluation on comparison of effect of sitagliptin and repaglinide in treatment of type 2 diabetes. Diabetes New World 21(13):1–3. https://doi.org/10.16658/j.cnki.1672-4062.2018.13.001

    Article  CAS  Google Scholar 

  40. Zhang CY, Fan XD, Qin Y et al (2018) Markov model of long-term effect of teneligliptin in the treatment of type 2 diabetes mellitus. Chin J Clin Pharmacol Ther 23(01):65–72

    CAS  Google Scholar 

  41. Shin JI (2019) Second-line glucose-lowering therapy in type 2 diabetes mellitus. Curr Diab Rep 19(8):54. https://doi.org/10.1007/s11892-019-1171-0

    Article  PubMed  Google Scholar 

  42. Alsahli M, Gerich JE (2013) Hypoglycemia. Endocrinol Metab Clin N Am 42(4):657–676. https://doi.org/10.1016/j.ecl.2013.07.002

    Article  Google Scholar 

  43. Richard KR, Shelburne JS, Kirk JK (2011) Tolerability of dipeptidyl peptidase-4 inhibitors: a review. Clin Ther 33(11):1609–1629. https://doi.org/10.1016/j.clinthera.2011.09.028

    Article  CAS  PubMed  Google Scholar 

  44. Grenet G, Mekhaldi S, Mainbourg S et al (2021) DPP-4 Inhibitors and respiratory infection: a systematic review and meta-analysis of the cardiovascular outcomes trials. Diabetes Care 44(3):36–37. https://doi.org/10.2337/dc20-2018

    Article  Google Scholar 

  45. Silverii GA, Dicembrini I, Nreu B et al (2020) Bullous pemphigoid and dipeptidyl peptidase-4 inhibitors: a meta-analysis of randomized controlled trials. Endocrine 69(3):504–507. https://doi.org/10.1007/s12020-020-02272-x

    Article  CAS  PubMed  Google Scholar 

  46. Yang W, Cai X, Zhang S et al (2021) Dipeptidyl peptidase-4 inhibitor treatment and the risk of bullous pemphigoid and skin-related adverse events: a systematic review and meta-analysis of randomized controlled trials. Diabetes Metab Res Rev 37(3):e3391. https://doi.org/10.1002/dmrr.3391

    Article  CAS  PubMed  Google Scholar 

  47. Ge L, Tian JH, Li YN et al (2018) Association between prospective registration and overall reporting and methodological quality of systematic reviews: a meta-epidemiological study. J Clin Epidemiol 93:45–55. https://doi.org/10.1016/j.jclinepi.2017.10.012

    Article  PubMed  Google Scholar 

  48. Kelly SE, Moher D, Clifford TJ (2016) Quality of conduct and reporting in rapid reviews: an exploration of compliance with PRISMA and AMSTAR guidelines. Syst Rev. https://doi.org/10.1186/s13643-016-0258-9

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

This study was supported by the Clinical Research Center for Metabolic Diseases, Gansu Province (No. 18JR2FA006).

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Author notes

  1. Zouxi Du and Tingting Lu have contributed equally to this work.

Authors and Affiliations

  1. The First School of Clinical Medicine, Lanzhou University, Lanzhou, 730000, China

    Zouxi Du & Limin Tian

  2. Department of Endocrinology, The Gansu Provincial Hospital, Lanzhou, 730000, China

    Limin Tian

  3. Institution of Clinical Research and Evidence-Based Medicine, The Gansu Provincial Hospital, Lanzhou, 730000, China

    Tingting Lu

  4. Department Pediatrics, The Gansu Provincial Hospital, Lanzhou, 730000, China

    Mingdong Gao

  5. Clinical Research Center for Metabolic Diseases, The Gansu Provincial Hospital, Lanzhou, 730000, China

    Zouxi Du, Mingdong Gao & Limin Tian

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  1. Zouxi Du
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Correspondence to Limin Tian.

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Du, Z., Lu, T., Gao, M. et al. Reporting and methodological quality of systematic reviews of DPP-4 inhibitors for patients with type 2 diabetes mellitus: an evidence-based mapping. Acta Diabetol 59, 1539–1549 (2022). https://doi.org/10.1007/s00592-022-01960-6

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  • DOI: https://doi.org/10.1007/s00592-022-01960-6

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