| 选择性二肽基肽酶抑制剂维格列汀与关节痛/骨关节炎发病风险相关性的系统评价 |
| 投稿时间：2016-03-19 修订日期：2016-06-16 点此下载全文 |
| 引用本文：陶伊琳,黄幼明,林惠娥.选择性二肽基肽酶抑制剂维格列汀与关节痛/骨关节炎发病风险相关性的系统评价[J].药学实践杂志,2016,34(6):540~545 |
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| 中文摘要:目的 系统评价选择性二肽基肽酶（DPP）-4抑制剂维格列汀与关节痛/骨关节炎发病风险的相关性。方法 利用计算机检索PubMed（1978.01-2016.02）、Cochrane Library（2015年第4期）、EMbase（1974.01-2016.02）、CBM（1978.01-2016.02）、CNKI（1978.01-2016.02）、VIP（1989.01-2016.02）的所有相关文献。根据Cochrane系统评价方法筛选维格列汀治疗2型糖尿病发生关节痛/骨关节炎的所有中、英文随机对照试验（RCT），对纳入文献进行数据提取和质量评价后，采用RevMan 5.3软件进行荟萃（Meta）分析。结果 共纳入10篇文献。Meta分析结果显示：使用维格列汀与使用其他降糖药或安慰剂相比，发生关节痛/骨关节炎的风险更高，差异有统计学意义[RR=1.24，95% CI（1.08，1.44），P=0.003]。进一步分析表明，各种剂量维格列汀组关节痛/骨关节炎的发病风险高于安慰剂组，差异有统计学意义[RR=1.35，95% CI（1.02，1.78），P=0.04]。尤其50 mg，1次/d维格列汀致关节痛/骨关节炎的发病风险显著高于安慰剂组，差异有统计学意义[RR=3.04，95% CI（1.44，6.44），P=0.004]。与其他降糖药比较，发现维格列汀组关节痛/骨关节炎的发病风险更高，差异有统计学意义[RR=1.19，95% CI（1.01，1.41），P=0.04]。结论 维格列汀可增加关节痛/骨关节炎的发病风险。尤其50 mg，1次/d维格列汀可使关节痛/骨关节炎的发病风险增加2倍。但其远期的安全性还需进行更多大样本、高质量、长期随访的RCT加以验证。 |
| 中文关键词:维格列汀 关节痛/骨关节炎 发病风险 荟萃分析 |
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| A systematic review on the correlation between selective dipeptidyl peptidase inhibitor vildagliptin and risk of arthralgia/osteoarthritis |
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| Abstract:Objective To systematically evaluate the correlation between selective dipeptidyl peptidase (DPP)-4 inhibitor, vildagliptin and risk of arthralgia/osteoarthritis. Methods The following databases of PubMed (1978 to February 2016), the Cochrane Library (Issue 4, 2015), EMbase (1974 to February 2016), CBM(1978 to February 2016), CNKI(1978 to February 2016), VIP(1989 to February 2016) were searched. The randomized controlled trials (RCTs) for vildagliptin related arthralgia/osteoarthritis were assessed using the Cochrane Collaboration system. The meta-analysis was performed with RevMan 5.3 software. Results Ten RCTs were included. Meta-analysis showed that vildagliptin had higher risk of arthralgia/osteoarthritis than other oral hypoglycemic agents or placebo (RR=1.24, 95%CI 1.08 to 1.44, P=0.003). Further analysis indicated that patients received different doses of vildagliptin had higher risk of arthralgia/osteoarthritis than the placebo group (RR=1.35, 95% CI 1.02 to 1.78, P=0.04). In particular, the group who took vildagliptin 50mg once daily had significantly higher risk of arthralgia/osteoarthritis than the placebo group (RR=3.04, 95%CI 1.44 to 6.44, P=0.004). In comparison of other oral hypoglycemic agents, the vildagliptin group had higher risk of arthralgia/osteoarthritis (RR=1.19, 95% CI 1.01 to 1.41, P=0.04). Conclusion Based on the Meta-analysis results, vildagliptin increases the risk of arthralgia/osteoarthritis. Especially vildagliptin 50mg once daily had two times higher risk than the placebo group. However the long-term safety of vidagliptin still needs to be confirmed by RCTs with larger samples and long term follow-up. |
| keywords:vildagliptin arthralgia/osteoarthritis risk Meta-analysis |
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