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Efficacy and safety of combination therapy with saxagliptin and metformin in patients with type 2 diabetes: a meta-analysis

WANG Ying-zheng*,LU Min,ZHOU Ying,CUI Yi-min.*Department of Pharmacy,Peking University First Hospital,Beijing 100035,China  
Objective To evaluate the efficacy and safety of combination therapy with saxagliptin and metformin in patients with type 2 diabetes.Methods "saxagliptin"and"metformin"were selected as keywords and PubMed and EMbase were searched.All randomized controlled trials(RCTs) of saxagliptin therapy in patients with type 2 diabetes were selected.According to the inclusion criteria,the articles were selected,evaluated,and meta-analyzed with RevMan 5.1 software.The levels of glycosylated haemoglobin(HbA1c) and fasting plasma glucose(FPG),the incidence of hypoglycemia after the treatment with saxagliptin + metformin(the saxagliptin group),placebo + metformin(the placebo control group) and other hypoglycemic drugs + metformin(the positive drug control group) were compared in patients with type 2 diabetes and their results were presented in mean difference(MD) or relative risk(RR) with 95% confidence interval(CI).Results A total of 5 RCTs were entered.The results of meta-analysis were as follows: the treatment effect of decrease in HbA1c levels in the saxagliptin group was better than that in the placebo control group(MD =-0.59,95% CI:-0.87 to-0.32,P = 0.00) and the positive drug control group(MD =-0.36,95% CI:-0.73 to-0.54,P = 0.00);the treatment effect of decrease in FPG levels in the saxagliptin group was better than that in the placebo control group(MD =-16.27,95% CI:-21.64 to-10.91,P = 0.00);however,the difference in treatment effect of decrease in FPG levels between the saxagliptin group and the positive drug control group was not statistically significant(MD =-2.75,95% CI:-22.52 to 17.01,P = 0.78);there was no significant difference in the incidence of hypoglycemia between the saxagliptin group and the placebo control group or the positive drug control group(RR = 0.55,95% CI: 0.15 to 2.09,P = 0.38).Conclusion The combination therapy with saxagliptin and metformin is effective to decrease the HbA1c and FPG levels in patients with type 2 diabetes.It also has a good safety profile.
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