Clinical Efficacy of Different Doses of Canagliflozin Combined with Metformin in the Treatment of Type 2 Diabetes Mellitus: a Meta-analysis
Background Canagliflozin (CANA) and metformin (MET) can both be used in the treatment of type 2 diabetes (T2DM) , but the clinical efficacy of combined use remains to be further clarified. Objective To elevate the efficacy and safety of CANA combined with MET in the treatment of T2DM, and to provide...
| Main Author: | |
|---|---|
| Format: | Article |
| Language: | zho |
| Published: |
Chinese General Practice Publishing House Co., Ltd
2022-05-01
|
| Series: | Zhongguo quanke yixue |
| Subjects: | |
| Online Access: | https://www.chinagp.net/fileup/1007-9572/PDF/zx20220073.pdf |
| _version_ | 1797217173830107136 |
|---|---|
| author | Yuying CHEN, Xiaodong LI, Yunzhao TANG, Daiqing LI |
| author_facet | Yuying CHEN, Xiaodong LI, Yunzhao TANG, Daiqing LI |
| author_sort | Yuying CHEN, Xiaodong LI, Yunzhao TANG, Daiqing LI |
| collection | DOAJ |
| description | Background Canagliflozin (CANA) and metformin (MET) can both be used in the treatment of type 2 diabetes (T2DM) , but the clinical efficacy of combined use remains to be further clarified. Objective To elevate the efficacy and safety of CANA combined with MET in the treatment of T2DM, and to provide clinical reference for the treatment of T2DM. Methods A systematic review of published randomized controlled trials (RCTs) of 100 mg and/or 300 mg CANA combined with MET for T2DM performed in PubMed, Cochrane Library, EMBase, Clinical Trials.gov, CNKI Database, VIP Database, Wanfang Databases from inception to 18 April 2021 were retrieved by computer, and the included references were retrieved manually. After literature screening, data extraction and quality evaluation, meta-analysis was performed using RevMan 5.3 software. Results A total of 9 RCTs with 6 224 patients were included. Meta-analysis results showed that the levels of glycosylated hemoglobin (HbA1c) , fasting blood glucose (FPG) , body weight, systolic blood pressure (SBP) , diastolic blood pressure (DBP) , and triacylglycerol (TG) in the 100 mg CANA combined with MET group and the 300 mg CANA combined with MET group were lower than placebo control group (P<0.05) . The levels of pancreatic β-cell function index (HOMA-β) , low-density lipoprotein cholesterol (LDL-C) , and high-density lipoprotein cholesterol (HDL-C) in the 100 mg CANA combined with MET group were higher than those in the placebo control group (P<0.05) . The levels of HbA1c and SBP in the 300 mg CANA combined with MET group were lower than those in the active control group, and the level of HOMA-β was higher than that in the active control group (P<0.05) . The FPG, body weight, DBP and TG in the 100 mg CANA combined with MET group and 300 mg CANA combined with MET group were lower than those in the active control group, and the levels of LDL-C and HDL-C were higher than those in the active control group (P<0.05) . The incidence of reproductive system infection (female) in the 100 mg CANA combined with MET group was higher than that in the placebo control group (P<0.05) . The incidence of reproductive system infection (female) and osmotic diuresis-related adverse events in the 300 mg CANA combined with MET group was higher than that in the placebo control group (P<0.05) . The incidence of reproductive system infection (male) , reproductive system infection (female) , and osmotic diuresis in the 100 mg CANA combined with MET group and 300 mg CANA combined with MET group was higher than that in the active control group (P<0.05) . Conclusion 100 mg and 300 mg of CANA combined with MET can effectively reduce HbA1c and FPG levels, body weight, blood pressure and TG levels, and increase LDL-C and HDL-C levels in T2DM patients. For patients with T2DM poorly controlled by MET, it may be considered in combination with CANA, but attention should be paid to infection of the reproductive system. Therefore, high-quality large-sample trials are still needed to confirm the long-term safety of different doses of CANA combined with MET. |
| first_indexed | 2024-04-24T11:57:39Z |
| format | Article |
| id | doaj.art-79d0b3daf1824b93b2f1a2905bbf919d |
| institution | Directory Open Access Journal |
| issn | 1007-9572 |
| language | zho |
| last_indexed | 2024-04-24T11:57:39Z |
| publishDate | 2022-05-01 |
| publisher | Chinese General Practice Publishing House Co., Ltd |
| record_format | Article |
| series | Zhongguo quanke yixue |
| spelling | doaj.art-79d0b3daf1824b93b2f1a2905bbf919d2024-04-09T03:16:00ZzhoChinese General Practice Publishing House Co., LtdZhongguo quanke yixue1007-95722022-05-01251518881896,190510.12114/j.issn.1007-9572.2022.0073Clinical Efficacy of Different Doses of Canagliflozin Combined with Metformin in the Treatment of Type 2 Diabetes Mellitus: a Meta-analysisYuying CHEN, Xiaodong LI, Yunzhao TANG, Daiqing LI01. NHC Key Laboratory of Hormones and Development/Tianjin Key Laboratory of Metabolic Diseases/Tianjin Institute of Endocrinology, Tianjin 300134, China;2. Tianjin Medical University Chu Hsien-I Memorial Hospital, Tianjin 300134, ChinaBackground Canagliflozin (CANA) and metformin (MET) can both be used in the treatment of type 2 diabetes (T2DM) , but the clinical efficacy of combined use remains to be further clarified. Objective To elevate the efficacy and safety of CANA combined with MET in the treatment of T2DM, and to provide clinical reference for the treatment of T2DM. Methods A systematic review of published randomized controlled trials (RCTs) of 100 mg and/or 300 mg CANA combined with MET for T2DM performed in PubMed, Cochrane Library, EMBase, Clinical Trials.gov, CNKI Database, VIP Database, Wanfang Databases from inception to 18 April 2021 were retrieved by computer, and the included references were retrieved manually. After literature screening, data extraction and quality evaluation, meta-analysis was performed using RevMan 5.3 software. Results A total of 9 RCTs with 6 224 patients were included. Meta-analysis results showed that the levels of glycosylated hemoglobin (HbA1c) , fasting blood glucose (FPG) , body weight, systolic blood pressure (SBP) , diastolic blood pressure (DBP) , and triacylglycerol (TG) in the 100 mg CANA combined with MET group and the 300 mg CANA combined with MET group were lower than placebo control group (P<0.05) . The levels of pancreatic β-cell function index (HOMA-β) , low-density lipoprotein cholesterol (LDL-C) , and high-density lipoprotein cholesterol (HDL-C) in the 100 mg CANA combined with MET group were higher than those in the placebo control group (P<0.05) . The levels of HbA1c and SBP in the 300 mg CANA combined with MET group were lower than those in the active control group, and the level of HOMA-β was higher than that in the active control group (P<0.05) . The FPG, body weight, DBP and TG in the 100 mg CANA combined with MET group and 300 mg CANA combined with MET group were lower than those in the active control group, and the levels of LDL-C and HDL-C were higher than those in the active control group (P<0.05) . The incidence of reproductive system infection (female) in the 100 mg CANA combined with MET group was higher than that in the placebo control group (P<0.05) . The incidence of reproductive system infection (female) and osmotic diuresis-related adverse events in the 300 mg CANA combined with MET group was higher than that in the placebo control group (P<0.05) . The incidence of reproductive system infection (male) , reproductive system infection (female) , and osmotic diuresis in the 100 mg CANA combined with MET group and 300 mg CANA combined with MET group was higher than that in the active control group (P<0.05) . Conclusion 100 mg and 300 mg of CANA combined with MET can effectively reduce HbA1c and FPG levels, body weight, blood pressure and TG levels, and increase LDL-C and HDL-C levels in T2DM patients. For patients with T2DM poorly controlled by MET, it may be considered in combination with CANA, but attention should be paid to infection of the reproductive system. Therefore, high-quality large-sample trials are still needed to confirm the long-term safety of different doses of CANA combined with MET.https://www.chinagp.net/fileup/1007-9572/PDF/zx20220073.pdfdiabetes mellitus, type 2|canagliflozin|metformin|treatment outcome|meta-analysis |
| spellingShingle | Yuying CHEN, Xiaodong LI, Yunzhao TANG, Daiqing LI Clinical Efficacy of Different Doses of Canagliflozin Combined with Metformin in the Treatment of Type 2 Diabetes Mellitus: a Meta-analysis Zhongguo quanke yixue diabetes mellitus, type 2|canagliflozin|metformin|treatment outcome|meta-analysis |
| title | Clinical Efficacy of Different Doses of Canagliflozin Combined with Metformin in the Treatment of Type 2 Diabetes Mellitus: a Meta-analysis |
| title_full | Clinical Efficacy of Different Doses of Canagliflozin Combined with Metformin in the Treatment of Type 2 Diabetes Mellitus: a Meta-analysis |
| title_fullStr | Clinical Efficacy of Different Doses of Canagliflozin Combined with Metformin in the Treatment of Type 2 Diabetes Mellitus: a Meta-analysis |
| title_full_unstemmed | Clinical Efficacy of Different Doses of Canagliflozin Combined with Metformin in the Treatment of Type 2 Diabetes Mellitus: a Meta-analysis |
| title_short | Clinical Efficacy of Different Doses of Canagliflozin Combined with Metformin in the Treatment of Type 2 Diabetes Mellitus: a Meta-analysis |
| title_sort | clinical efficacy of different doses of canagliflozin combined with metformin in the treatment of type 2 diabetes mellitus a meta analysis |
| topic | diabetes mellitus, type 2|canagliflozin|metformin|treatment outcome|meta-analysis |
| url | https://www.chinagp.net/fileup/1007-9572/PDF/zx20220073.pdf |
| work_keys_str_mv | AT yuyingchenxiaodongliyunzhaotangdaiqingli clinicalefficacyofdifferentdosesofcanagliflozincombinedwithmetformininthetreatmentoftype2diabetesmellitusametaanalysis |