肠促胰素类药物安全性系统评价再评价

发布时间：2018-06-22 19:50

本文选题：糖尿病 + 二肽基肽酶-抑制剂　；参考：《中国临床药理学杂志》2017年21期

【摘要】：目的系统评价再评价二肽基肽酶-4(DPP-4)抑制剂和胰高糖素样肽-1(GLP-1)受体激动剂的安全性。方法计算机检索Cochrane Library、Pub Med、中国知网(CNKI)、维普数据库(VIP)、中国生物医学文献数据库(CBM)及万方数据库,并进行手工检索,筛选有关DPP-4抑制剂和GLP-1受体激动剂治疗糖尿病安全性的系统评价,检索时间截至2016年10月。用多系统评价评估问卷(AMSTAR)量表评价文献质量,用Rev Man5.3软件进行Meta分析。结果最终纳入46篇文献,AMSTAR评分均为5分以上。结果显示,DPP-4抑制剂与安慰剂相比,不增加低血糖、胃肠道、鼻咽炎、头痛、感染及心血管不良事件风险;而与其他降糖药相比,低血糖发生率低,同时心血管不良事件发生率低。GLP-1受体激动剂与安慰剂相比,低血糖和胃肠道不良反应发生率高,不增加鼻咽炎、头痛及心血管不良事件风险,不增加体重;而与其他降糖药物相比,低血糖发生率低,胃肠道反应发生率高,同时降低体重。DPP-4抑制剂和GLP-1受体激动剂均不增加胰腺炎风险。结论 DPP-4抑制剂安全性较高,而GLP-1受体激动剂会增加胃肠道不良反应和低血糖风险。
[Abstract]:Objective to evaluate the safety of dipeptidyl peptidase-4 (DPP-4) inhibitor and glucagon-like peptide-1 (GLP-1) receptor agonist. Methods the Cochrane Library Pub Med, CNKI, VIP, CBM and Wanfang databases were searched by computer. The systematic evaluation of the safety of DPP-4 inhibitors and GLP-1 agonists in the treatment of diabetes mellitus was conducted. The search time is up to October 2016. The literature quality was evaluated with the multiple system Evaluation questionnaire (AMSTAR) and Meta-analysis with the software Rev Man5.3. Results the AMSTAR scores of 46 articles were all above 5. The results showed that the DPP-4 inhibitor did not increase the risk of hypoglycemia, gastrointestinal tract, nasopharyngitis, headache, infection and cardiovascular adverse events compared with placebo, but had a lower incidence of hypoglycemia than other hypoglycemic drugs. At the same time, the incidence of cardiovascular adverse events was lower. GLP-1 receptor agonists had higher incidence of hypoglycemia and gastrointestinal adverse reactions than placebo, and did not increase the risk of nasal pharyngitis, headache and cardiovascular adverse events, and did not increase body weight. Compared with other hypoglycemic drugs, the incidence of hypoglycemia was lower and gastrointestinal reaction was higher than that of other hypoglycemic drugs, while the weight loss of .DPP-4 inhibitor and GLP-1 receptor agonist did not increase the risk of pancreatitis. Conclusion DPP-4 inhibitor is safe, while GLP-1 receptor agonist can increase gastrointestinal adverse reaction and hypoglycemia risk.
【作者单位】：暨南大学药学院;广州军区广州总医院药剂科;
【基金】：广州市科技计划基金资助项目(201509010012)
【分类号】：R977.15

【相似文献】