Comparison of gliclazide vs linagliptin on hypoglycemia and cardiovascular events in type 2 diabetes mellitus: A systematic review  

作　　者：Viswanathan Mohan Subhash Wangnoo Sambit Das Rajnish Dhediya Kumar Gaurav 

机构地区：[1]Department of Diabetes,Madras Diabetes Research Foundation&Dr Mohan’s Diabetes Specialties Centre,Chennai 600086,Tamil Nadu,India [2]Department of Diabetes,Apollo Hospital Education and Research Foundation,New Delhi 110001,India [3]Department of Endocrinology,Endeavour Clinics,Bhubaneswar 750017,India [4]Medical Affairs,Dr.Reddy’s Laboratories Ltd,Hyderabad 500016,India

出　　处：《World Journal of Diabetes》2022年第12期1168-1183,共16页世界糖尿病杂志（英文版）（电子版）

摘　　要：BACKGROUND Cardiovascular outcome trials have demonstrated cardiovascular safety of glimepiride(a sulfonylureas) against dipeptidyl peptidase-4 inhibitor linagliptin.Gliclazide(another newer sulfonylureas) has shown similar glycemic efficacy and 50% decreased risk of hypoglycemia compared to glimepiride.AIM Considering the absence of cardiovascular outcome trials for gliclazide, we decided to conduct a systematic review of the literature to assess the cardiovascular(CV) safety by assessing the risk for major adverse CV events and hypoglycemia risk of gliclazide vs linagliptin in patients with type 2 diabetes(T2D).METHODS This systematic review followed the current Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to analyze all the clinical studies published from 2008 that compared the two drugs in patients with T2D with no risk of CV disease(CVD). We included only evidence designated high quality by the Oxford Center for Evidence-based Medicine-Levels of Evidence.RESULTS Eight clinical studies were included in the narrative descriptive analysis(gliclazide: 5 and linagliptin: 3). The CV safety of gliclazide in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation trial and of linagliptin in the Cardiovascular and Renal Microvascular Outcome Study With Linagliptin(CARMELINA) and CARdiovascular Outcome study of LINAgliptin vs glimepiride in patients with T2D(CAROLINA)trials were excluded from the comparative analysis as these trials demonstrated CV and hypoglycemia benefits in patients at high risk of CVD. However, since these are landmark trials,they were discussed in brief to show the CV benefits and low hypoglycemia risk of gliclazide and linagliptin. We did not find any study comparing gliclazide with linagliptin. Hence, direct comparison of their major adverse CV events and hypoglycemia risk could not be carried out.However, the literature meeting the inclusion criteria showed that both drugs were effective in achieving the desire

关 键 词：LINAGLIPTIN GLICLAZIDE HYPOGLYCEMIA Major cardiovascular adverse events Type 2 diabetes 

分 类 号：R587.1[医药卫生—内分泌]