Safety and Efficiency of Dipeptidyl Peptidase IV Inhibitors in Patients with Diabetic Kidney Disease: A Systematic Review and Meta-Analysis
Background: To investigate the safety and efficiency of dipeptidyl peptidase-4 (DPP-4) inhibitors in patients with diabetic kidney disease. Methods: We conducted a comprehensive literature search across multiple databases, including Embase, PubMed, CNKI, and the Cochrane Central Register of Controll...
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Elsevier
2024-01-01
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| Series: | Current Therapeutic Research |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0011393X2400033X |
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| author | Adili Tuersun, M.A. Munire Mohetaer, M.A. Guanxin Hou, B.A. Gang Cheng, Ph.D |
| author_facet | Adili Tuersun, M.A. Munire Mohetaer, M.A. Guanxin Hou, B.A. Gang Cheng, Ph.D |
| author_sort | Adili Tuersun, M.A. |
| collection | DOAJ |
| description | Background: To investigate the safety and efficiency of dipeptidyl peptidase-4 (DPP-4) inhibitors in patients with diabetic kidney disease. Methods: We conducted a comprehensive literature search across multiple databases, including Embase, PubMed, CNKI, and the Cochrane Central Register of Controlled Trials, from inception to January 2024. The search focused on randomized controlled trials (RCTs) that directly compared DPP-4 inhibitors with placebos or other glucose-lowering therapies. A meta-analysis was performed to pool data and quantify the therapeutic effects and safety profile of DPP-4 inhibitors in DKD. Results: Twenty-three RCTs with 16,378 participants were included. DPP-4 inhibitors significantly reduced urinary albumin-to-creatinine ratio (UACR) and HbA1c levels compared to controls (UACR: SMD -0.23, 95% CI: -0.41, -0.06; p = 0.01; HbA1c: SMD -0.32, 95% CI: -0.51, -0.14; p = 0.0006). A higher proportion of patients in the DPP-4 inhibitor group achieved at least a 30% reduction in UACR (OR = 1.73, 95% CI: 1.10, 2.73; p = 0.02). However, estimated glomerular filtration rate (eGFR) and serum creatinine (SCr) changes were similar between groups (eGFR: p = 1.00; SCr: p = 0.67). No significant differences were found in all-cause mortality (OR = 0.94, 95% CI: 0.83, 1.06; p = 0.31) or hypoglycemia risk (OR = 1.10, 95% CI: 0.80, 1.52; p = 0.54) between the DPP-4 inhibitor and control groups. Conclusions: DPP-4 inhibitors exhibit renoprotective properties, indicated by significant reductions in UACR and HbA1c levels. They do not appear to increase the risk of hypoglycemia, presenting a favorable safety profile when compared to placebo or alternative antidiabetic agents. |
| format | Article |
| id | doaj-art-cec42e313e4c472c87bdab6c282ec2e1 |
| institution | OA Journals |
| issn | 0011-393X |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
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| series | Current Therapeutic Research |
| spelling | doaj-art-cec42e313e4c472c87bdab6c282ec2e12025-08-20T01:56:48ZengElsevierCurrent Therapeutic Research0011-393X2024-01-0110110076310.1016/j.curtheres.2024.100763Safety and Efficiency of Dipeptidyl Peptidase IV Inhibitors in Patients with Diabetic Kidney Disease: A Systematic Review and Meta-AnalysisAdili Tuersun, M.A.0Munire Mohetaer, M.A.1Guanxin Hou, B.A.2Gang Cheng, Ph.D3School of Life Sciences and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, Liaoning, ChinaSchool of Business Administration, Shenyang Pharmaceutical University, Shenyang, ChinaDepartment of Pharmacy, General Hospital of Northern Theater Command, Shenyang, ChinaDepartment of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China; Address correspondence to: Gang Cheng, Department of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China.Background: To investigate the safety and efficiency of dipeptidyl peptidase-4 (DPP-4) inhibitors in patients with diabetic kidney disease. Methods: We conducted a comprehensive literature search across multiple databases, including Embase, PubMed, CNKI, and the Cochrane Central Register of Controlled Trials, from inception to January 2024. The search focused on randomized controlled trials (RCTs) that directly compared DPP-4 inhibitors with placebos or other glucose-lowering therapies. A meta-analysis was performed to pool data and quantify the therapeutic effects and safety profile of DPP-4 inhibitors in DKD. Results: Twenty-three RCTs with 16,378 participants were included. DPP-4 inhibitors significantly reduced urinary albumin-to-creatinine ratio (UACR) and HbA1c levels compared to controls (UACR: SMD -0.23, 95% CI: -0.41, -0.06; p = 0.01; HbA1c: SMD -0.32, 95% CI: -0.51, -0.14; p = 0.0006). A higher proportion of patients in the DPP-4 inhibitor group achieved at least a 30% reduction in UACR (OR = 1.73, 95% CI: 1.10, 2.73; p = 0.02). However, estimated glomerular filtration rate (eGFR) and serum creatinine (SCr) changes were similar between groups (eGFR: p = 1.00; SCr: p = 0.67). No significant differences were found in all-cause mortality (OR = 0.94, 95% CI: 0.83, 1.06; p = 0.31) or hypoglycemia risk (OR = 1.10, 95% CI: 0.80, 1.52; p = 0.54) between the DPP-4 inhibitor and control groups. Conclusions: DPP-4 inhibitors exhibit renoprotective properties, indicated by significant reductions in UACR and HbA1c levels. They do not appear to increase the risk of hypoglycemia, presenting a favorable safety profile when compared to placebo or alternative antidiabetic agents.http://www.sciencedirect.com/science/article/pii/S0011393X2400033XDiabetic kidney diseaseDipeptidyl peptidase-4 inhibitorsGlomerular filtration rateUrinary albumin-to-creatinine ratioEstimated glomerular filtration rate |
| spellingShingle | Adili Tuersun, M.A. Munire Mohetaer, M.A. Guanxin Hou, B.A. Gang Cheng, Ph.D Safety and Efficiency of Dipeptidyl Peptidase IV Inhibitors in Patients with Diabetic Kidney Disease: A Systematic Review and Meta-Analysis Current Therapeutic Research Diabetic kidney disease Dipeptidyl peptidase-4 inhibitors Glomerular filtration rate Urinary albumin-to-creatinine ratio Estimated glomerular filtration rate |
| title | Safety and Efficiency of Dipeptidyl Peptidase IV Inhibitors in Patients with Diabetic Kidney Disease: A Systematic Review and Meta-Analysis |
| title_full | Safety and Efficiency of Dipeptidyl Peptidase IV Inhibitors in Patients with Diabetic Kidney Disease: A Systematic Review and Meta-Analysis |
| title_fullStr | Safety and Efficiency of Dipeptidyl Peptidase IV Inhibitors in Patients with Diabetic Kidney Disease: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Safety and Efficiency of Dipeptidyl Peptidase IV Inhibitors in Patients with Diabetic Kidney Disease: A Systematic Review and Meta-Analysis |
| title_short | Safety and Efficiency of Dipeptidyl Peptidase IV Inhibitors in Patients with Diabetic Kidney Disease: A Systematic Review and Meta-Analysis |
| title_sort | safety and efficiency of dipeptidyl peptidase iv inhibitors in patients with diabetic kidney disease a systematic review and meta analysis |
| topic | Diabetic kidney disease Dipeptidyl peptidase-4 inhibitors Glomerular filtration rate Urinary albumin-to-creatinine ratio Estimated glomerular filtration rate |
| url | http://www.sciencedirect.com/science/article/pii/S0011393X2400033X |
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