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10.1111/bcp.13059

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suck abstract from ncbi


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pmid27426428
      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]


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