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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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          Author and article information

          Journal
          Endocrine
          Endocrine
          Springer Nature
          1559-0100
          1355-008X
          Jun 2016
          : 52
          : 3
          Affiliations
          [1 ] Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University Thessaloniki, Hippokratio General Hospital, 49 Konstantinoupoleos Street, 54642, Thessaloníki, Greece.
          [2 ] Diabetes Centre, Second Medical Department, Aristotle University Thessaloniki, Thessaloníki, Greece.
          [3 ] Second Medical Department, Democritus University Thrace, Alexandroupoli, Greece.
          [4 ] Second Medical Department, Aristotle University Thessaloniki, Thessaloníki, Greece.
          [5 ] Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University Thessaloniki, Hippokratio General Hospital, 49 Konstantinoupoleos Street, 54642, Thessaloníki, Greece. atsapas@auth.gr.
          [6 ] Diabetes Centre, Second Medical Department, Aristotle University Thessaloniki, Thessaloníki, Greece. atsapas@auth.gr.
          [7 ] Harris Manchester College, University of Oxford, Oxford, UK. atsapas@auth.gr.
          Article
          10.1007/s12020-015-0841-1
          10.1007/s12020-015-0841-1
          26714458
          0c389bf7-f09a-4bab-b644-f8dd3d18a5f8
          History

          Vildagliptin,DPP-4 inhibitors,Meta-analysis,Systematic review

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