The efficacy of sodium glucose co-transporter 2 inhibitor combined with dipeptidyl peptidase-4 inhibitor in treating type 2 diabetes mellitus: a meta-analysis of randomized controlled trials

Objective To systematically evaluate the efficacy and safety of sodium-glucose co-transporter 2 (SGLT2) inhibitor combined with dipeptidyl peptidase-4 (DPP-4) inhibitor in the treatment of type 2 diabetes patients. Methods PubMed, Cochrane Library,EMBASE, the WeiPu (VIP), the China National Knowledge Infrastructure (CNKI) and China Biology Medicine disc (CBMdisc) were used for searching relevant randomized controlled trials published till December, 2019. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software and Stata1 4.0 software. Results A total of 14 studies were included, involving 5 110 patients. Meta analysis showed that the SGLT2 inhibitor combined with DPP-4 inhibitor group was significantly better than the control group in reducing glycosylated hemoglobin (HbA1c) MD=-0.71, 95% CI (-0.82, -0.61), P<0.00001, body weight (BW) MD =-1.97, 95% CI (-2.15, -1.79), P<0.00001. Conclusions SGLT2 inhibitor combined with DPP-4 inhibitor can effectively reduce the glycosylated hemoglobin and body weight in type 2 diabetic patients. This effect will not be different due to the length of treatment course, background medication and the type of SGLT2 inhibitor.