Neurological Manifestation of Incretin-Based Therapies in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis

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dc.contributor.authorLe, Gao
dc.contributor.authorShuqing, Yu
dc.contributor.authorAndrea, Cipriani
dc.contributor.authorShanshan, Wu
dc.contributor.authorYi, Huang
dc.contributor.authorZilu, Zhang
dc.contributor.authorJun, Yang
dc.contributor.authorYixin, Sun
dc.contributor.authorZhirong, Yang
dc.contributor.authorSanbao, Chai
dc.contributor.authorYuan, Zhang
dc.contributor.authorLinong, Ji
dc.contributor.authorSiyan, Zhan
dc.contributor.authorFeng, Sun
dc.date.accessioned2019-10-11T14:35:16Z
dc.date.available2019-10-11T14:35:16Z
dc.date.issued2019-03-03
dc.description.abstractAs a new class of antidiabetic drug, incretin-based therapies, which include dipeptidyl peptidase-4 inhibitors (DPP-4Is) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs), have raised concerns about symptoms of withdrawal in patients with type 2 diabetes mellitus (T2DM), such as dizziness and headache. To systematically evaluate whether incretin-based therapies may lead to dizziness and headache in patients with T2DM compared to other traditional antidiabetic drugs or placebo. We searched Medline, Embase, the Cochrane library, and clinicaltrials.gov from inception through June 23, 2017, to identify randomized controlled trials of the safety of DPP-4Is or GLP-1 RAs versus placebo or other antidiabetic drugs in T2DM patients. We used the network meta-analysis under the frequentist framework to compare the association between multiple antidiabetic drugs and dizziness and headache. A total of 233 clinical trials with nine treatments and 147,710 patients were included: two incretin-based therapies, one placebo, and six traditional antidiabetic drugs (metformin, insulin, sulfonylurea, thiazolidinediones, alpha-glucosidase inhibitor, and sodium-glucose co-transporter 2). Compared to insulin, thiazolidinediones, or placebo, GLP-1 RAs statistically significantly increased the risk of dizziness (odds ratios [ORs]: 1.92, 1.57, and 1.40, respectively) and headache (ORs: 1.34, 1.41, and 1.18, respectively). DPP-4Is increased the risk of headache (OR: 1.22, 95% confidence interval [CI]: 1.02 to 1.46; moderate quality) and dizziness (OR: 1.46, 95% CI: 1.05 to 2.03; moderate quality) compared to insulin. Of the incretin-based therapies, DPP-4Is had a lower risk of dizziness than GLP-1 RAs (OR: 0.76, 95% CI: 0.67 to 0.87; high quality). Ranking probability analysis indicated that GLP-1 RAs may have the greatest risk of both dizziness and headache among the nine treatments (22.5% and 23.4%, respectively), whereas DPP-4Is were in the middle (46.2% and 45.0%, respectively). Incretin-based therapies increase the risk of dizziness and headache compared to insulin, thiazolidinediones, and placebo.en_US
dc.description.sponsorshipThis study was supported by the National Natural Science Foundation of China (81302508, 71673003).en_US
dc.description.urihttp://www.aginganddisease.org/article/0000/2152-5250/ad-0-0-0-1903230948-1.shtmlen_US
dc.format.extent2 filesen_US
dc.genrejournal articlesen_US
dc.identifierdoi:10.13016/m209fk-9t0u
dc.identifier.citationGao Le, Yu Shuqing, Cipriani Andrea, Wu Shanshan, Huang Yi, Zhang Zilu, Yang Jun, Sun Yixin, Yang Zhirong, Chai Sanbao, Zhang Yuan, Ji Linong, Zhan Siyan, Sun Feng. Neurological Manifestation of Incretin-Based Therapies in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis[J]. , 2019, 0(0): https://doi.org/10.14336/AD.2019.0303en_US
dc.identifier.urihttps://doi.org/10.14336/AD.2019.0303
dc.identifier.urihttp://hdl.handle.net/11603/15854
dc.language.isoen_USen_US
dc.publisherAging and Diseaseen_US
dc.relation.isAvailableAtThe University of Maryland, Baltimore County (UMBC)
dc.relation.ispartofUMBC Mathematics Department Collection
dc.relation.ispartofUMBC Faculty Collection
dc.rightsThis item is likely protected under Title 17 of the U.S. Copyright Law. Unless on a Creative Commons license, for uses protected by Copyright Law, contact the copyright holder or the author.
dc.rightsAttribution 4.0 International (CC BY 4.0)*
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/*
dc.subjectIncretin-based therapiesen_US
dc.subjecttype 2 diabetesen_US
dc.subjectnetwork meta-analysisen_US
dc.subjectdizzinessen_US
dc.subjectheadacheen_US
dc.titleNeurological Manifestation of Incretin-Based Therapies in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysisen_US
dc.typeTexten_US

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