卡格列净、恩格列净、达格列净治疗T2DM患者安全性的网状Meta分析

孔文强; 文露; 张春燕; 杜彪

doi:10.16016/j.1000-5404.201804062

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卡格列净、恩格列净、达格列净治疗T2DM患者安全性的网状Meta分析

临床医学 | 更新时间：2026-01-09

- 卡格列净、恩格列净、达格列净治疗T2DM患者安全性的网状Meta分析
- Safety of canagliflozin, empagliflozin and dapagliflozin for T2DM patients: a network meta-analysis
- 第三军医大学学报 2018年40卷第19期页码：1792-1804
- 作者机构：
  
  1.646000 四川泸州，西南医科大学药学院
  2.610072 成都，四川省人民医院药学部
  3.637000 四川南充，川北医学院药学院
  4.4040004 重庆万州，重庆三峡中心医院药学部
- 作者简介：
  
  [ 杜彪，电话：(023)58103184，E-mail：dubiao1967@aliyun.com DU Biao, Tel:86-23-58103184, E-mail:dubiao1967@aliyun.com
- 基金信息：
  
  重庆市社会事业与民生保障科技创新专项(CSTC2015shmszx120073);重庆市社会事业与民生保障科技创新专项(CSTC2017shmsA130105);重庆市万州区科技计划基金资助项目(201403055)
- DOI：10.16016/j.1000-5404.201804062
  中图分类号： R587.1;R589.1
- 收稿：2018-04-06，
  
  修回：2018-07-06，
  
  纸质出版：2018-10-15
- 稿件说明：
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孔文强, 文露, 张春燕, 等. 卡格列净、恩格列净、达格列净治疗T2DM患者安全性的网状Meta分析[J]. 第三军医大学学报, 2018,40(19):1792-1804.

Wenqiang KONG, Lu WEN, Chunyan ZHANG, et al. Safety of canagliflozin, empagliflozin and dapagliflozin for T2DM patients: a network meta-analysis[J]. Journal of Third Military Medical University, 2018, 40(19): 1792-1804.
孔文强, 文露, 张春燕, 等. 卡格列净、恩格列净、达格列净治疗T2DM患者安全性的网状Meta分析[J]. 第三军医大学学报, 2018,40(19):1792-1804. DOI： 10.16016/j.1000-5404.201804062.

Wenqiang KONG, Lu WEN, Chunyan ZHANG, et al. Safety of canagliflozin, empagliflozin and dapagliflozin for T2DM patients: a network meta-analysis[J]. Journal of Third Military Medical University, 2018, 40(19): 1792-1804. DOI： 10.16016/j.1000-5404.201804062.

摘要

目的

采用Meta分析研究评价卡格列净、恩格列净、达格列净治疗2型糖尿病患者的安全性。

方法

检索PubMed、CENTRAL、Embase数据库，检索时限从建库到2018年1月，纳入有关RCT文献，传统Meta分析和网状Meta分析用STATA14完成。

结果

共纳入34篇文献，含21 216名患者的35项RCT。Meta分析结果显示，卡格列净、恩格列净、达格列净与安慰剂和阳性药物相比：①均不会增加因不良反应退出人数，差异无统计学意义(

0.05)；②能够显著增加生殖器感染的人数，且女性感染人数要明显多于男性，差异均有统计学意义(

0.05)；③仅达格列净可轻微增加尿路感染人数[

=1.26，95%

(1.02~1.55)，

=0.039

]

。④卡格列净与恩格列净[

=1.53，95%

(1.02~2.30)

0.05

]

、安慰剂[

=1.74，95%

(1.32~2.30)

0.05

]

相比，明显增加了低血糖发生人数。⑤恩格列净和达格列净与DPP-4抑制剂、GLP-1激动剂、二甲双胍

、安慰剂相比，低血糖发生人数差异无统计学意义(

0.05)。

结论

卡格列净、恩格列净、达格列净治疗2型糖尿病，仅增加生殖器感染人数，有较好的耐受性和安全性；3种药物中恩格列净耐受性和安全性可能最好。

Abstract

Objective

To evaluate the safety of canagliflozin

empagliflozin and dapagliflozin in treatment of type 2 diabetes mellitus (T2DM) by network meta-analysis.

Methods

The databases including PubMed

Embase

and CENTRAL from inception to January 2018 were searched for eligible randomized controlled trials (RCTs) evaluating the SGLT2 inhibitors in T2DM patients. Conventional meta-analysis and network meta-analysis were performed by STATA14.

Results

A total of 34 studies

including 35 RCTs

involving 21 216 patients were collected. Meta-analysis showed that when compared with placebo and positive agents: ① the 3 drugs didn't increase the number of patients who required discontinuation due to adverse events (

0.05); ② they significantly increased the number of genital infections

especially in women

with significant differences (

0.05). ③ Only dapagliflozin slightly raised the number of urinary tract infections (UTIs) (

=1.26

95%

: 1.02~1.55

=0.039); ④ Compared with empagliflozin (

=1.53

95%

: 1.02~2.30

0.05) and placebo (

=1.74

95%

: 1.32~2.30

0.05)

canagliflozin slightly increased the incidence of hypoglycemia; ⑤ Empagliflozin and dapagliflozin didn't increase the incidence of hypoglycemia

when compared with DPP-4 inhibitors

GLP-1 agonists

metformin and placebo (

0.05).

Conclusion

Canagliflozin

empagliflozin and dapagliflozin show better tolerance and safety

though increasing the risk of genital infections in treatment of T2DM. Among them

empagliflozin may be the best in tolerance and durability.

关键词

Keywords

references

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