不同剂量替西帕肽治疗2型糖尿病安全性的meta分析  

Meta-analysis of the safety of different doses of teixepatide in the treatment of type 2 diabetes mellitus

作　　者：赵翊如 张琳[1] 方振威[1] 石秀锦[1] 张梦迪 林阳[1] ZHAO Yi-ru;ZHANG Lin;FANG Zhen-wei;SHI Xiu-jin;ZHANG Meng-di;LIN Yang(Department of Pharmacy,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;Department of clinical pharmacology,College of pharmaceutical Sciences,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京安贞医院药事部,北京100029 [2]首都医科大学药学院临床药学系,北京100069

出　　处：《临床药物治疗杂志》2023年第10期33-39,共7页Clinical Medication Journal

摘　　要：目的系统评价不同剂量替西帕肽治疗2型糖尿病的安全性。方法计算机检索PubMed、Embase、the Cochrane Library、Web of Science、中国期刊全文数据库、万方数据知识服务平台、维普资讯等数据库,收集不同剂量替西帕肽治疗2型糖尿病的相关研究,检索时限为建库至2022年12月。采用RevMan 5.4软件进行meta分析。结果共纳入8项研究,均为RCTs,合计3534例患者。meta分析结果显示,每周5 mg替西帕肽组导致停药的不良事件(RR=0.70,95%CI:0.56~0.87,P=0.001)、腹泻(RR=0.83,95%CI:0.71~0.97,P=0.02)、呕吐(RR=0.54,95%CI:0.43~0.69,P<0.00001)、食欲减退(RR=0.69,95%CI:0.56~0.84,P=0.0003)、注射部位反应(RR=0.56,95%CI:0.37~0.84,P=0.006)、低血糖(RR=0.80,95%CI:0.66~0.97,P=0.02)的发生率显著低于每周15 mg替西帕肽组;两组患者便秘、恶心、消化不良、鼻咽炎、胆石症、胰腺炎、严重不良事件、主要心血管不良事件(MACE)、严重低血糖、过敏反应和糖尿病视网膜病变发生率比较,差异均无统计学意义(P>0.05)。结论在使用高剂量替西帕肽治疗2型糖尿病时,需重点关注腹泻、呕吐、食欲减退、注射部位反应及低血糖事件。Objective To systematically evaluate the safety of different doses of tirzepatide in the treatment of type 2 dia⁃betes mellitus(T2DM).Methods Pubmed,Embase,Cochrane Library,Web of Science,CNKI,Wanfang Data,VIP databases were searched to screen for studies on the safety of different doses of tirzepatide for the treatment of T2DM.Meta-analysis was performed using Revman 5.4 software.Results A total of 8 RCTs were included with 3534 patients.The search time is from the establishment of the databases to December 2022.Meta-analysis showed adverse events leading to treatment discontinua⁃tion(RR=0.70,95%CI:0.56 to 0.87,P=0.001),diarrhoea(RR=0.83,95%CI:0.71 to 0.97,P=0.02),vomiting(RR=0.54,95%CI:0.43 to 0.69,P<0.00001),decreased appetite(RR=0.69,95%CI:0.56 to 0.84,P=0.0003),injection-site reaction(RR=0.56,95%CI:0.37 to 0.84,P=0.006)and hypoglycemia(RR=0.80,95%CI:0.66 to 0.97,P=0.02)in the 5 mg per week tizepatide group were significantly lower than those of 15 mg per week group.However,the differences were not statisti⁃cally significant between the two groups for constipation,nausea,dyspepsia,nasopharyngitis,cholelithiasis,pancreatitis,serious adverse events,major adverse cardiovascular events(MACE),severe hypoglycaemia,hypersensitivity and diabetic retinopathy(P>0.05).Conclusion Diarrhoea,vomiting,decreased appetite,injection-site reaction and hypoglycemia need to be addressed with high doses of tirzepatide in the treatment of type 2 diabetes.

关 键 词：替西帕肽 2型糖尿病 安全性 META分析 

分 类 号：R977.15[医药卫生—药品] R969.3[医药卫生—药学]