德谷胰岛素利拉鲁肽注射液与甘精胰岛素利司那肽注射液治疗2型糖尿病的网状Meta分析  

Network meta-analysis of Insulin degludec and liraglutide injection versus Insulin glargine and lixisenatide injection in the treatment of type 2 diabetes mellitus

作　　者：王笑梅 游晓炎 秦佳丽 刘洋[1] 王宪英[1] WANG Xiaomei;YOU Xiaoyan;QIN Jiali;LIU Yang;WANG Xianying(Dept.of Pharmacy,Hebei Medical University Third Hospital,Shijiazhuang 050051,China;Graduate School,Hebei Medical University,Shijiazhuang 050017,China)

机构地区：[1]河北医科大学第三医院药剂科,石家庄050051 [2]河北医科大学研究生院,石家庄050017

出　　处：《中国药房》2025年第7期874-880,共7页China Pharmacy

基　　金：河北省医学科学研究课题(No.20240829)。

摘　　要：目的系统评价德谷胰岛素利拉鲁肽注射液(IDegLira)和甘精胰岛素利司那肽注射液(iGlarLixi)治疗2型糖尿病(T2DM)的有效性和安全性,为临床治疗T2DM提供循证依据。方法计算机检索PubMed、Embase、the Cochrane Library、中国知网、万方数据、维普网,检索时限从建库起至2024年8月。根据纳入排除标准,严格筛选随机对照试验(RCT),从中提取资料并对纳入研究进行偏倚风险评价,采用Stata 14.0软件进行网状Meta分析。结果共纳入15项RCT,包括9513例患者,涉及4种治疗方案:IDegLira、iGlarLixi、德谷胰岛素(IDeg)、甘精胰岛素(iGlar)。在糖化血红蛋白(HbA1c)、空腹血糖、体重和不良事件发生率结局指标方面,IDegLira与i GlarLixi差异均无统计学意义(P>0.05);在低血糖事件发生率结局指标方面,IDegLira显著优于iGlarLixi[OR=0.41,95%CI(0.18,0.91),P<0.05]。累积排序概率曲线下面积(SUCRA)排序结果显示,在降低HbA1c方面,iGlarLixi(84.5%)>IDegLira(81.7%);在降低空腹血糖方面,IDegLira(71.3%)>iGlarLixi(20.0%);在降低体重方面,IDegLira(90.7%)>iGlarLixi(61.8%);在降低低血糖事件发生率方面,IDegLira(95.5%)>i GlarLixi(9.7%);在降低不良事件发生率方面,IDegLira(27.1%)>i GlarLixi(14.5%)。结论i GlarLixi在降低HbA1c方面效果更好,IDegLira在降低空腹血糖、体重方面治疗效果更好;IDegLira低血糖风险最低。OBJECTIVE To systematically evaluate the efficacy and safety of Insulin degludec and liraglutide injection(IDegLira)and Insulin glargine and lixisenatide injection(iGlarLixi)in the treatment of type 2 diabetes mellitus(T2DM),and provide an evidence-based basis for the clinical treatment of T2DM.METHODS Computerized searches of PubMed,Embase,the Cochrane Library,CNKI,Wanfang data and VIP were conducted with a time frame from the inception to August 2024.Randomized controlled trials(RCTs)were rigorously screened according to inclusion and exclusion criteria,from which information was extracted and included studies were evaluated for risk of bias.Network meta-analysis was performed using Stata 14.0 software.RESULTS A total of 15 RCTs,including 9513 patients,were included,involving four treatment regimens:IDegLira,iGlarLixi,insulin degludec(IDeg),and insulin glargine(iGlar).The differences between IDegLira and iGlarLixi were not statistically significant(P>0.05)for the outcome indexes of glycosylated hemoglobin(HbA1c),fasting blood glucose,body weight,and the incidence of adverse events(P>0.05);for the outcome index of the incidence of hypoglycemic events,IDegLira was significantly superior to iGlarLixi[OR=0.41,95%CI(0.18,0.91),P<0.05].Surface under the cumulative ranking curve(SUCRA)results showed that iGlarLixi(84.5%)>IDegLira(81.7%)in lowering HbA1c;IDegLira(71.3%)>iGlarLixi(20.0%)in lowering fasting blood glucose;IDegLira(90.7%)>iGlarLixi(61.8%)in lowering body weight;IDegLira(95.5%)>iGlarLixi(9.7%)in reducing the incidence of hypoglycemic events;and IDegLira(27.1%)>iGlarLixi(14.5%)in reducing the incidence of adverse events.CONCLUSIONS iGlarLixi has better therapeutic efficacy in reducing HbA1c;IDegLira has better therapeutic efficacy in reducing fasting blood glucose and body weight.IDegLira has the lowest risk of hypoglycemia.

关 键 词：德谷胰岛素利拉鲁肽注射液 甘精胰岛素利司那肽注射液 德谷胰岛素 甘精胰岛素 2型糖尿病 体重增加 低血糖 

分 类 号：R587.1[医药卫生—内分泌] R977.15[医药卫生—内科学]