Comparative efficacy and safety of glucose-lowering drugs in children and adolescents with type 2 diabetes: A systematic review and network meta-analysis
ObjectiveType 2 diabetes is more common in adults, but is becoming the major concern in children and adolescent recently. This study aimed to provide additional pharmaceutical management for children and adolescents with type 2 diabetes by assessing the efficacy and safety of several glucose-lowerin...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2022.897776/full |
| _version_ | 1811309943095033856 |
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| author | Sijia Wu Sijia Wu Yina He Yina He Yutong Wu Yutong Wu Yiman Ji Yiman Ji Lei Hou Lei Hou Xinhui Liu Xinhui Liu Yilei Ge Yilei Ge Yuanyuan Yu Yuanyuan Yu Yifan Yu Yifan Yu Yun Wei Yun Wei Fengtong Qian Fengtong Qian Qingxin Luo Qingxin Luo Yue Feng Yue Feng Yiping Feng Yiping Feng Jiongjiong Wang Jiongjiong Wang Meiling Huo Hongkai Li Hongkai Li Fuzhong Xue Fuzhong Xue Yunxia Liu Yunxia Liu |
| author_facet | Sijia Wu Sijia Wu Yina He Yina He Yutong Wu Yutong Wu Yiman Ji Yiman Ji Lei Hou Lei Hou Xinhui Liu Xinhui Liu Yilei Ge Yilei Ge Yuanyuan Yu Yuanyuan Yu Yifan Yu Yifan Yu Yun Wei Yun Wei Fengtong Qian Fengtong Qian Qingxin Luo Qingxin Luo Yue Feng Yue Feng Yiping Feng Yiping Feng Jiongjiong Wang Jiongjiong Wang Meiling Huo Hongkai Li Hongkai Li Fuzhong Xue Fuzhong Xue Yunxia Liu Yunxia Liu |
| author_sort | Sijia Wu |
| collection | DOAJ |
| description | ObjectiveType 2 diabetes is more common in adults, but is becoming the major concern in children and adolescent recently. This study aimed to provide additional pharmaceutical management for children and adolescents with type 2 diabetes by assessing the efficacy and safety of several glucose-lowering drugs.MethodsSearches were performed in PubMed, Medline, Ovid, Cochrane Controlled Register of Trials (CENTRAL), and ClinicalTrials.gov that reported the efficacy and safety of drugs for children and adolescents with type 2 diabetes. Pooled effects were calculated by frequentist fixed effects network meta-analyses and additive network meta-analyses.ResultsA total of 12 trials assessing eight glucose-lowering drugs were included, which compose of seven trials with monotherapy and five trials with combination therapies. Network meta-analysis results showed compared to placebo, saxagliptin+metformin (mean difference (MD) -1.91% [-2.85%, -0.97%]), liraglutide+metformin (MD -1.45% [-1.65%, -1.26%]), and liraglutide (MD -0.90% [-1.35%, -0.45%]) were the top 3 drugs that significantly reduced hemoglobin A1c (HbA1c). Sitagliptin+metformin, dapagliflozin, exenatide-2mcg, linagliptin-5mg, metformin, exenatide-5/10mcg, glimepiride, and sitagliptin also showed significant reduction in HbA1c. There were no significant differences between treatments in the incidence of adverse events, except that liraglutide+metformin had significant adverse effect such as abdominal pain. In addition, dapagliflozin, sitagliptin+metformin, and saxagliptin+metformin showed better efficacy compared with FDA-approved drugs.ConclusionsThe top 10 treatments of type 2 diabetes in children and adolescents aged 10–17 years were saxagliptin+metformin, liraglutide+metformin, liraglutide, dapagliflozin, exenatide–2 mcg, sitagliptin+metformin, linagliptin–5 mg, linagliptin–1 mg, metformin, and exenatide–5/10 mcg.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=284897, identifier CRD42021284897. |
| first_indexed | 2024-04-13T09:51:11Z |
| format | Article |
| id | doaj.art-a59af18d9be742d785471d7a7129ee25 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-13T09:51:11Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-a59af18d9be742d785471d7a7129ee252022-12-22T02:51:36ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-08-011310.3389/fendo.2022.897776897776Comparative efficacy and safety of glucose-lowering drugs in children and adolescents with type 2 diabetes: A systematic review and network meta-analysisSijia Wu0Sijia Wu1Yina He2Yina He3Yutong Wu4Yutong Wu5Yiman Ji6Yiman Ji7Lei Hou8Lei Hou9Xinhui Liu10Xinhui Liu11Yilei Ge12Yilei Ge13Yuanyuan Yu14Yuanyuan Yu15Yifan Yu16Yifan Yu17Yun Wei18Yun Wei19Fengtong Qian20Fengtong Qian21Qingxin Luo22Qingxin Luo23Yue Feng24Yue Feng25Yiping Feng26Yiping Feng27Jiongjiong Wang28Jiongjiong Wang29Meiling Huo30Hongkai Li31Hongkai Li32Fuzhong Xue33Fuzhong Xue34Yunxia Liu35Yunxia Liu36Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaInstitute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaInstitute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaInstitute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaInstitute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaInstitute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaInstitute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaInstitute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaInstitute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaInstitute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaInstitute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaInstitute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaInstitute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaInstitute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaInstitute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaInstitute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, ChinaQilu Children’s Hospital of Shandong University, Jinan, ChinaDepartment of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaInstitute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaInstitute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaInstitute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, ChinaObjectiveType 2 diabetes is more common in adults, but is becoming the major concern in children and adolescent recently. This study aimed to provide additional pharmaceutical management for children and adolescents with type 2 diabetes by assessing the efficacy and safety of several glucose-lowering drugs.MethodsSearches were performed in PubMed, Medline, Ovid, Cochrane Controlled Register of Trials (CENTRAL), and ClinicalTrials.gov that reported the efficacy and safety of drugs for children and adolescents with type 2 diabetes. Pooled effects were calculated by frequentist fixed effects network meta-analyses and additive network meta-analyses.ResultsA total of 12 trials assessing eight glucose-lowering drugs were included, which compose of seven trials with monotherapy and five trials with combination therapies. Network meta-analysis results showed compared to placebo, saxagliptin+metformin (mean difference (MD) -1.91% [-2.85%, -0.97%]), liraglutide+metformin (MD -1.45% [-1.65%, -1.26%]), and liraglutide (MD -0.90% [-1.35%, -0.45%]) were the top 3 drugs that significantly reduced hemoglobin A1c (HbA1c). Sitagliptin+metformin, dapagliflozin, exenatide-2mcg, linagliptin-5mg, metformin, exenatide-5/10mcg, glimepiride, and sitagliptin also showed significant reduction in HbA1c. There were no significant differences between treatments in the incidence of adverse events, except that liraglutide+metformin had significant adverse effect such as abdominal pain. In addition, dapagliflozin, sitagliptin+metformin, and saxagliptin+metformin showed better efficacy compared with FDA-approved drugs.ConclusionsThe top 10 treatments of type 2 diabetes in children and adolescents aged 10–17 years were saxagliptin+metformin, liraglutide+metformin, liraglutide, dapagliflozin, exenatide–2 mcg, sitagliptin+metformin, linagliptin–5 mg, linagliptin–1 mg, metformin, and exenatide–5/10 mcg.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=284897, identifier CRD42021284897.https://www.frontiersin.org/articles/10.3389/fendo.2022.897776/fullsystematic review & meta-analysisglucose-lowering drugsfrequentist network meta- analysisadolescentsglycosylated hemoglobin A1ctype 2 diabetes |
| spellingShingle | Sijia Wu Sijia Wu Yina He Yina He Yutong Wu Yutong Wu Yiman Ji Yiman Ji Lei Hou Lei Hou Xinhui Liu Xinhui Liu Yilei Ge Yilei Ge Yuanyuan Yu Yuanyuan Yu Yifan Yu Yifan Yu Yun Wei Yun Wei Fengtong Qian Fengtong Qian Qingxin Luo Qingxin Luo Yue Feng Yue Feng Yiping Feng Yiping Feng Jiongjiong Wang Jiongjiong Wang Meiling Huo Hongkai Li Hongkai Li Fuzhong Xue Fuzhong Xue Yunxia Liu Yunxia Liu Comparative efficacy and safety of glucose-lowering drugs in children and adolescents with type 2 diabetes: A systematic review and network meta-analysis Frontiers in Endocrinology systematic review & meta-analysis glucose-lowering drugs frequentist network meta- analysis adolescents glycosylated hemoglobin A1c type 2 diabetes |
| title | Comparative efficacy and safety of glucose-lowering drugs in children and adolescents with type 2 diabetes: A systematic review and network meta-analysis |
| title_full | Comparative efficacy and safety of glucose-lowering drugs in children and adolescents with type 2 diabetes: A systematic review and network meta-analysis |
| title_fullStr | Comparative efficacy and safety of glucose-lowering drugs in children and adolescents with type 2 diabetes: A systematic review and network meta-analysis |
| title_full_unstemmed | Comparative efficacy and safety of glucose-lowering drugs in children and adolescents with type 2 diabetes: A systematic review and network meta-analysis |
| title_short | Comparative efficacy and safety of glucose-lowering drugs in children and adolescents with type 2 diabetes: A systematic review and network meta-analysis |
| title_sort | comparative efficacy and safety of glucose lowering drugs in children and adolescents with type 2 diabetes a systematic review and network meta analysis |
| topic | systematic review & meta-analysis glucose-lowering drugs frequentist network meta- analysis adolescents glycosylated hemoglobin A1c type 2 diabetes |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2022.897776/full |
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