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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Br+J+Clin+Pharmacol
2016 ; 82
(5
): 1291-1302
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Hypoglycaemia when adding sulphonylurea to metformin: a systematic review and
network meta-analysis
#MMPMID27426428
Andersen SE
; Christensen M
Br J Clin Pharmacol
2016[Nov]; 82
(5
): 1291-1302
PMID27426428
show ga
AIMS: The risk of hypoglycaemia may differ among sulphonylureas (SUs), but
evidence from head-to-head comparisons is sparse. Performing a network
meta-analysis to use indirect evidence from randomized controlled trials (RCTs),
we compared the relative risk of hypoglycaemia with newer generation SUs when
added to metformin. METHODS: A systematic review identified RCTs lasting 12-52
weeks and evaluating SUs added to inadequate metformin monotherapy (?1000 mg/day)
in type 2 diabetes. Adding RCTs investigating the active comparators from the
identified SU trials, we established a coherent network. Hypoglycaemia of any
severity was the primary end point. RESULTS: Thirteen trials of SUs and 14 of
oral non-SU antihyperglycaemic agents (16?260 patients) were included. All
reported hypoglycaemia only as adverse events. Producing comparable reductions in
HbA(1C) of -0.66 to -0.84% (-7 to -9 mmol/mol), the risk of hypoglycaemia was
lowest with gliclazide compared to glipizide (OR 0.22, CrI: 0.05 to 0.96),
glimepiride (OR 0.40, CrI: 0.13 to 1.27), and glibenclamide (OR 0.21, CrI: 0.03
to 1.48). A major limitation is varying definitions of hypoglycaemia across
studies. CONCLUSIONS: When added to metformin, gliclazide was associated with the
lowest risk of hypoglycaemia between the newer generation SUs. Clinicians should
consider the risk of hypoglycaemia agent-specific when selecting an SU agent.
|Diabetes Mellitus, Type 2/drug therapy
[MESH]
|Drug Therapy, Combination/adverse effects
[MESH]
|Humans
[MESH]
|Hypoglycemia/*chemically induced
[MESH]
|Hypoglycemic Agents/adverse effects
[MESH]
|Metformin/*adverse effects/therapeutic use
[MESH]