Dipeptidyl peptidase-4 inhibitors and risk of arthralgia: A systematic review and meta-analysis |
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Institution: | 1. Department of Pharmacy, Peking University Third Hospital, 49, Huayuan North Road, 100191 Beijing, Haidian District, China;2. Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Science, Peking University, Beijing, China;3. Department of Orthopaedic, Peking University Third Hospital, Beijing, China |
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Abstract: | BackgroundThe US Food and Drug Administration has warned that treatment with dipeptidyl peptidase (DPP)-4 inhibitors may promote serious arthralgia. However, the clinical evidence for this is relatively lacking.ObjectiveFor this reason, a systematic review and meta-analysis of randomized controlled trials (RCTs) were carried out to determine the relationship between DPP-4 inhibitors and risk of arthralgia, and also to investigate any potential risk factors.MethodsAn extensive electronic search for RCTs comparing DPP-4 inhibitors with any comparators was performed up to July 2016. Outcomes of interest were overall and serious arthralgia. Summary risk ratios (RRs) with 95% confidence intervals (CIs) were calculated.ResultsA total of 67 RCTs (involving 79,110 patients) was ultimately included. Pooled results showed that DPP-4 inhibitors were associated with a slightly but significantly increased risk of overall arthralgia (RR: 1.13, 95% CI: 1.04–1.22; P = 0.003) and a non-significant increased risk of serious arthralgia (RR: 1.44, 95% CI: 0.83–2.51; P = 0.20). Also, subgroup analyses showed that add-on/combination therapy and longer diabetes duration (> 5 years) were possible factors associated with the increased risk of overall arthralgia.ConclusionThese findings suggest that DPP-4 inhibitors can increase the risk of arthralgia. Thus, the benefits of glycaemic control must be weighed against the risk of arthralgia when prescribing DPP-4 inhibitors. Further studies are now needed to identify and confirm these risk factors. |
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Keywords: | Arthralgia Dipeptidyl peptidase-4 inhibitors Meta-analysis Systematic review DPP-4"} {"#name":"keyword" "$":{"id":"kw0030"} "$$":[{"#name":"text" "_":"Dipeptidyl peptidase-4 FDA"} {"#name":"keyword" "$":{"id":"kw0040"} "$$":[{"#name":"text" "_":"Food and Drug Administration GIP"} {"#name":"keyword" "$":{"id":"kw0050"} "$$":[{"#name":"text" "_":"Glucose-dependent insulinotropic peptide GLP-1"} {"#name":"keyword" "$":{"id":"kw0060"} "$$":[{"#name":"text" "_":"Glucagon-like peptide-1 IDF"} {"#name":"keyword" "$":{"id":"kw0070"} "$$":[{"#name":"text" "_":"International Diabetes Federation MedDRA"} {"#name":"keyword" "$":{"id":"kw0080"} "$$":[{"#name":"text" "_":"Medical Dictionary for Regulatory Activities RA"} {"#name":"keyword" "$":{"id":"kw0090"} "$$":[{"#name":"text" "_":"Rheumatoid arthritis RCTs"} {"#name":"keyword" "$":{"id":"kw0100"} "$$":[{"#name":"text" "_":"Randomized controlled trials |
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