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Systematic review and meta-analysis of vildagliptin for treatment of type 2 diabetes

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Abstract

This systematic review and meta-analysis provides an update on the efficacy and safety of vildagliptin for treatment of type 2 diabetes mellitus (T2DM). We searched MEDLINE, COCHRANE, EMBASE and the drug manufacturer’s website for randomised controlled trials of vildagliptin in patients with T2DM. Sixty-nine studies (28,006 patients) were included in the meta-analysis. Compared with placebo vildagliptin reduced HbA1c (weighted mean difference WMD −0.69 %; 95 % CI −0.83 to −0.56 %; I 2 = 82 %), and it was as effective as other antidiabetic agents (WMD −0.01 %; 95 % CI −0.16 to 0.14 %; I 2 = 93 %), without increasing the risk for hypoglycemia (OR 0.83; 95 % CI 0.59 to 1.16; I 2 = 0 % vs. placebo, and OR 0.19; 95 % CI 0.15 to 0.24; I 2 = 78 % versus active comparators). However, it was associated with an increase in the incidence of arthralgia compared with other comparators (OR 1.23; 95 % CI 1.02 to 1.48; I 2 = 0 %). On the contrary, vildagliptin did not increase the incidence of pancreatitis (OR 0.97; 95 % CI 0.37 to 2.53; I 2 = 0 %), serious adverse events (OR 0.98; 95 % CI 0.88 to 1.09; I 2 = 0 %) or death (OR 1.10, 95 % CI 0.75 to 1.61; I 2 = 0 %). Finally, odds ratio (OR) for heart failure, and overall cardiovascular and cerebrovascular events was 0.77 (95 % CI 0.46 to 1.30; I 2 = 0 %) and 0.91 (95 % CI 0.73 to 1.14; I 2 = 0 %), respectively. Vildagliptin is an effective and safe therapeutic option for patients with T2DM, both as monotherapy and as add-on treatment.

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Acknowledgement

This work was partly supported by Novartis Pharmaceuticals Corporation. All authors participated in the development and writing of the article, approved the final manuscript for publication, and take full responsibility for the content of the article.

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  1. Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University Thessaloniki, Hippokratio General Hospital, 49 Konstantinoupoleos Street, 54642, Thessaloníki, Greece

    Eleni Bekiari, Chrysoula Rizava, Eleni Athanasiadou, Aris Liakos, Thomas Karagiannis, Maria Mainou & Apostolos Tsapas

  2. Diabetes Centre, Second Medical Department, Aristotle University Thessaloniki, Thessaloníki, Greece

    Eleni Bekiari, Konstantinos Papatheodorou, Maria Rika & Apostolos Tsapas

  3. Second Medical Department, Democritus University Thrace, Alexandroupoli, Greece

    Konstantinos Papatheodorou

  4. Second Medical Department, Aristotle University Thessaloniki, Thessaloníki, Greece

    Panagiota Boura

  5. Harris Manchester College, University of Oxford, Oxford, UK

    Apostolos Tsapas

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  1. Eleni Bekiari
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A.T. has received lecture or consultancy fees from AstraZeneca, Boehringer Ingelheim and MSD, and research support from Novartis, Novo Nordisk and Sanofi. E.A. has received research support from Novartis. The remaining authors declare no competing interests.

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Bekiari, E., Rizava, C., Athanasiadou, E. et al. Systematic review and meta-analysis of vildagliptin for treatment of type 2 diabetes. Endocrine 52, 458–480 (2016). https://doi.org/10.1007/s12020-015-0841-1

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