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Diabetes Obes Metab. 2018 Apr;20(4):1029-1033. doi: 10.1111/dom.13147. Epub 2017 Dec 5.

Direct head-to-head comparison of glycaemic durability of dipeptidyl peptidase-4 inhibitors and sulphonylureas in patients with type 2 diabetes mellitus: A meta-analysis of long-term randomized controlled trials.

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Department of Endocrinology, Chinese PLA General Hospital, Beijing, China.
Department of Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, China.
Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Diabetes Research Centre of Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Medical Affairs, MSD China Holding Company, Shanghai, China.


We performed a meta-analysis of randomized controlled trials (RCTs) to compare the long-term glycaemic durability of dipeptidyl-peptidase 4 (DPP-4) inhibitors vs that of sulphonylureas (SUs) in patients with type 2 diabetes mellitus (T2DM), in terms of the changes in glycated haemoglobin (HbA1c) levels from an intermediate time point (26 or 52 weeks) to 104 weeks of treatment. The Medline (PubMed), Embase (Ovid), and CENTER (Cochrane Library) databases were searched for relevant RCTs. Eight RCTs were included. Compared with SUs, DPP-4 inhibitors were associated with significantly smaller increases in the HbA1c level from 24 to 28 weeks to 104 weeks (mean difference [MD]: -0.16%, 95% confidence interval [CI]: -0.21 to -0.11; P < .001) and from 52 weeks to 104 weeks (MD -0.06%, 95% CI -0.10 to -0.02; P = .001). No significant heterogeneities were detected among the included comparisons (I2  = 0%). These results suggest that long-term treatment with DPP-4 inhibitors confers better durability of glycaemic response than treatment with SUs in patients with T2DM, which may indicate that DPP-4 inhibitors better preserve islet β-cell function compared with SUs.


dipeptidyl peptidase-4 inhibitors; glycaemic durability; glycated haemoglobin; meta-analysis; sulphonylureas

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