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选择性二肽基肽酶抑制剂维格列汀与关节痛/骨关节炎发病风险相关性的系统评价

陶伊琳 黄幼明 林惠娥

陶伊琳, 黄幼明, 林惠娥. 选择性二肽基肽酶抑制剂维格列汀与关节痛/骨关节炎发病风险相关性的系统评价[J]. 药学实践与服务, 2016, 34(6): 540-545. doi: 10.3969/j.issn.1006-0111.2016.06.015
引用本文: 陶伊琳, 黄幼明, 林惠娥. 选择性二肽基肽酶抑制剂维格列汀与关节痛/骨关节炎发病风险相关性的系统评价[J]. 药学实践与服务, 2016, 34(6): 540-545. doi: 10.3969/j.issn.1006-0111.2016.06.015
TAO Yilin, HUANG Youming, LIN Huie. A systematic review on the correlation between selective dipeptidyl peptidase inhibitor vildagliptin and risk of arthralgia/osteoarthritis[J]. Journal of Pharmaceutical Practice and Service, 2016, 34(6): 540-545. doi: 10.3969/j.issn.1006-0111.2016.06.015
Citation: TAO Yilin, HUANG Youming, LIN Huie. A systematic review on the correlation between selective dipeptidyl peptidase inhibitor vildagliptin and risk of arthralgia/osteoarthritis[J]. Journal of Pharmaceutical Practice and Service, 2016, 34(6): 540-545. doi: 10.3969/j.issn.1006-0111.2016.06.015

选择性二肽基肽酶抑制剂维格列汀与关节痛/骨关节炎发病风险相关性的系统评价

doi: 10.3969/j.issn.1006-0111.2016.06.015

A systematic review on the correlation between selective dipeptidyl peptidase inhibitor vildagliptin and risk of arthralgia/osteoarthritis

  • 摘要: 目的 系统评价选择性二肽基肽酶(DPP)-4抑制剂维格列汀与关节痛/骨关节炎发病风险的相关性。 方法 利用计算机检索PubMed(1978.01-2016.02)、Cochrane Library(2015年第4期)、EMbase(1974.01-2016.02)、CBM(1978.01-2016.02)、CNKI(1978.01-2016.02)、VIP(1989.01-2016.02)的所有相关文献。根据Cochrane系统评价方法筛选维格列汀治疗2型糖尿病发生关节痛/骨关节炎的所有中、英文随机对照试验(RCT),对纳入文献进行数据提取和质量评价后,采用RevMan 5.3软件进行荟萃(Meta)分析。 结果 共纳入10篇文献。Meta分析结果显示:使用维格列汀与使用其他降糖药或安慰剂相比,发生关节痛/骨关节炎的风险更高,差异有统计学意义[RR=1.24,95% CI(1.08,1.44),P=0.003]。进一步分析表明,各种剂量维格列汀组关节痛/骨关节炎的发病风险高于安慰剂组,差异有统计学意义[RR=1.35,95% CI(1.02,1.78),P=0.04]。尤其50 mg,1次/d维格列汀致关节痛/骨关节炎的发病风险显著高于安慰剂组,差异有统计学意义[RR=3.04,95% CI(1.44,6.44),P=0.004]。与其他降糖药比较,发现维格列汀组关节痛/骨关节炎的发病风险更高,差异有统计学意义[RR=1.19,95% CI(1.01,1.41),P=0.04]。 结论 维格列汀可增加关节痛/骨关节炎的发病风险。尤其50 mg,1次/d维格列汀可使关节痛/骨关节炎的发病风险增加2倍。但其远期的安全性还需进行更多大样本、高质量、长期随访的RCT加以验证。
  • [1] Gu D, Reynolds K,Duan X, et al. Prevalence of diabetes and impaired fasting glucose in the Chinese adult population:international collaborative study of cardiovascular disease in Asia (InterASIA)[J]. Diabetologia, 2003, 46(9):1190-1198.
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    [6] American Diabetes Association. Standards of medical care in diabetes——2015:summary of revisions[J]. Diabetes Care,2015,38(Suppl):S4.
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    [8] FDA safety alert. FDA Drug Safety Communication:FDA warns that DPP-4 inhibitors for type 2 diabetes may cause severe joint pain[EB/OL].[2015-08-28] (2016-02-29).http://www.fda.gov/Drugs/DrugSafety/ucm459579.htm.
    [9] Higgins J, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0[EB/OL].[2011-03-01] (2016-02-29).http://handbook.cochrane.org/
    [10] CLAF237A2329. A multicenter, double-blind, randomized, active controlled, parallel group study to compare the effect of 12 weeks treatment with LAF23750 mg bid to 50 mg qd in patients with type 2 diabetes with HbAlc 9-11%[EB/OL].[2007-03-16] (2016-02-29). http://www.novctrd.com/ctrdWebApp/clinicaltrialrepository/displayFile.do?trialResult=2297.
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    [12] Filozof C, Schwartz S, Foley JE. Effect of vildagliptin as add-on therapy to a low-dose metformin[J]. World J Diabetes,2010,1(1):19-26.
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    [16] Strain WD, Lukashevich V,Kothny W, et al. Individualised treatment targets for elderly patients with type 2 diabetes using vildagliptin add-on or lone therapy (INTERVAL):a 24 week, randomised, double-blind, placebo-controlled study[J]. Lancet,2013,382(9890):409-416.
    [17] Scherbaum WA, Schweizer A, Mari A, et al. Evidence that vildagliptin attenuates deterioration of glycaemic control during 2-year treatment of patients with type 2 diabetes and mild hyperglycaemia[J]. Diabetes Obes Metab,2008,10(11):1114-1124.
    [18] Scherbaum WA, Schweizer A, Mari A, et al. Efficacy and tolerability of vildagliptin in drug-naïve patients with type 2 diabetes and mild hyperglycaemia[J]. Diabetes Obes Metab, 2008,10(8):675-682.
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选择性二肽基肽酶抑制剂维格列汀与关节痛/骨关节炎发病风险相关性的系统评价

doi: 10.3969/j.issn.1006-0111.2016.06.015

摘要: 目的 系统评价选择性二肽基肽酶(DPP)-4抑制剂维格列汀与关节痛/骨关节炎发病风险的相关性。 方法 利用计算机检索PubMed(1978.01-2016.02)、Cochrane Library(2015年第4期)、EMbase(1974.01-2016.02)、CBM(1978.01-2016.02)、CNKI(1978.01-2016.02)、VIP(1989.01-2016.02)的所有相关文献。根据Cochrane系统评价方法筛选维格列汀治疗2型糖尿病发生关节痛/骨关节炎的所有中、英文随机对照试验(RCT),对纳入文献进行数据提取和质量评价后,采用RevMan 5.3软件进行荟萃(Meta)分析。 结果 共纳入10篇文献。Meta分析结果显示:使用维格列汀与使用其他降糖药或安慰剂相比,发生关节痛/骨关节炎的风险更高,差异有统计学意义[RR=1.24,95% CI(1.08,1.44),P=0.003]。进一步分析表明,各种剂量维格列汀组关节痛/骨关节炎的发病风险高于安慰剂组,差异有统计学意义[RR=1.35,95% CI(1.02,1.78),P=0.04]。尤其50 mg,1次/d维格列汀致关节痛/骨关节炎的发病风险显著高于安慰剂组,差异有统计学意义[RR=3.04,95% CI(1.44,6.44),P=0.004]。与其他降糖药比较,发现维格列汀组关节痛/骨关节炎的发病风险更高,差异有统计学意义[RR=1.19,95% CI(1.01,1.41),P=0.04]。 结论 维格列汀可增加关节痛/骨关节炎的发病风险。尤其50 mg,1次/d维格列汀可使关节痛/骨关节炎的发病风险增加2倍。但其远期的安全性还需进行更多大样本、高质量、长期随访的RCT加以验证。

English Abstract

陶伊琳, 黄幼明, 林惠娥. 选择性二肽基肽酶抑制剂维格列汀与关节痛/骨关节炎发病风险相关性的系统评价[J]. 药学实践与服务, 2016, 34(6): 540-545. doi: 10.3969/j.issn.1006-0111.2016.06.015
引用本文: 陶伊琳, 黄幼明, 林惠娥. 选择性二肽基肽酶抑制剂维格列汀与关节痛/骨关节炎发病风险相关性的系统评价[J]. 药学实践与服务, 2016, 34(6): 540-545. doi: 10.3969/j.issn.1006-0111.2016.06.015
TAO Yilin, HUANG Youming, LIN Huie. A systematic review on the correlation between selective dipeptidyl peptidase inhibitor vildagliptin and risk of arthralgia/osteoarthritis[J]. Journal of Pharmaceutical Practice and Service, 2016, 34(6): 540-545. doi: 10.3969/j.issn.1006-0111.2016.06.015
Citation: TAO Yilin, HUANG Youming, LIN Huie. A systematic review on the correlation between selective dipeptidyl peptidase inhibitor vildagliptin and risk of arthralgia/osteoarthritis[J]. Journal of Pharmaceutical Practice and Service, 2016, 34(6): 540-545. doi: 10.3969/j.issn.1006-0111.2016.06.015
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