TY - JOUR
T1 - Effect of dipeptidyl peptidase-4 inhibitors on circulating tumor necrosis factor-α concentrations
T2 - A systematic review and meta-analysis of controlled trials
AU - Atkin, Stephen
AU - Katsiki, Niki
AU - Banach, Maciej
AU - Mikhailidis, Dimitri P.
AU - Pirro, Matteo
AU - Sahebkar, Amirhossein
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Objective Dipeptidyl peptidase-4 (DPP-4) inhibitors improve glycemic control in patients with type 2 diabetes mellitus. There are also reports of an effect of these drugs in reducing inflammation through inhibition of tumor necrosis factor-α (TNF-α) that is an important mediator for several inflammatory processes. The present systematic review and meta-analysis were performed to evaluate the effect of DPP-4 inhibitors on circulating TNF-α levels in T2DM patients. Methods A systematic review and a meta-analysis were undertaken on all controlled trials of DPP-4 inhibitors that included measurement of TNF-α. The search included PubMed-Medline, Scopus, ISI Web of Knowledge and Google Scholar databases. Quantitative data synthesis was performed using a random-effects model, with standardized mean difference (SMD) and 95% confidence interval (CI) as summary statistics. Meta-regression and leave-one-out sensitivity analysis were performed to assess the modifiers of treatment response. Results Eight eligible articles (6 with sitagliptin and 2 with vildagliptin) comprising 9 treatment arms were selected for this meta-analysis. Meta-analysis suggested a significant reduction of circulating TNF-α concentrations following treatment with DPP-4 inhibitors (SMD: − 1.84, 95% CI: − 2.88, − 0.80, p = 0.001). The effect size was robust in the sensitivity analysis and not mainly driven by a single study. A subgroup analysis did not suggest any significant difference between the TNF-α-lowering activity of sitagliptin (SMD: − 1.49, 95% CI: − 2.89, − 0.10) and vildagliptin (SMD: − 2.80, 95% CI: − 4.98, − 0.61) (p = 0.326). Conclusion This meta-analysis of the 8 available controlled trials showed that DPP-4 inhibition in patients with type 2 diabetes mellitus was associated with significant reductions in plasma TNF-α levels with no apparent difference between sitagliptin and vildagliptin.
AB - Objective Dipeptidyl peptidase-4 (DPP-4) inhibitors improve glycemic control in patients with type 2 diabetes mellitus. There are also reports of an effect of these drugs in reducing inflammation through inhibition of tumor necrosis factor-α (TNF-α) that is an important mediator for several inflammatory processes. The present systematic review and meta-analysis were performed to evaluate the effect of DPP-4 inhibitors on circulating TNF-α levels in T2DM patients. Methods A systematic review and a meta-analysis were undertaken on all controlled trials of DPP-4 inhibitors that included measurement of TNF-α. The search included PubMed-Medline, Scopus, ISI Web of Knowledge and Google Scholar databases. Quantitative data synthesis was performed using a random-effects model, with standardized mean difference (SMD) and 95% confidence interval (CI) as summary statistics. Meta-regression and leave-one-out sensitivity analysis were performed to assess the modifiers of treatment response. Results Eight eligible articles (6 with sitagliptin and 2 with vildagliptin) comprising 9 treatment arms were selected for this meta-analysis. Meta-analysis suggested a significant reduction of circulating TNF-α concentrations following treatment with DPP-4 inhibitors (SMD: − 1.84, 95% CI: − 2.88, − 0.80, p = 0.001). The effect size was robust in the sensitivity analysis and not mainly driven by a single study. A subgroup analysis did not suggest any significant difference between the TNF-α-lowering activity of sitagliptin (SMD: − 1.49, 95% CI: − 2.89, − 0.10) and vildagliptin (SMD: − 2.80, 95% CI: − 4.98, − 0.61) (p = 0.326). Conclusion This meta-analysis of the 8 available controlled trials showed that DPP-4 inhibition in patients with type 2 diabetes mellitus was associated with significant reductions in plasma TNF-α levels with no apparent difference between sitagliptin and vildagliptin.
KW - Diabetes
KW - DPP-iv
KW - Inflammation
KW - Meta-analysis
KW - Tumor necrosis factor-α
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U2 - 10.1016/j.jdiacomp.2017.05.016
DO - 10.1016/j.jdiacomp.2017.05.016
M3 - Review article
C2 - 28647512
AN - SCOPUS:85020859436
VL - 31
SP - 1458
EP - 1464
JO - Journal of Diabetes and its Complications
JF - Journal of Diabetes and its Complications
SN - 1056-8727
IS - 9
ER -