A systematic review on the correlation between selective dipeptidyl peptidase inhibitor vildagliptin and risk of arthralgia/osteoarthritis / 药学实践杂志

ABSTRACT

Objective To systematically evaluate the correlation between selective dipeptidyl peptidase (DPP)-4 inhibi-tor ,vildagliptin and risk of arthralgia/osteoarthritis .Methods The following databases of PubMed (1978 to February 2016) , the Cochrane Library (Issue 4 ,2015) ,EMbase (1974 to February 2016) ,CBM(1978 to February 2016) ,CNKI(1978 to Feb-ruary 2016) ,VIP(1989 to February 2016) were searched .The randomized controlled trials (RCTs) for vildagliptin related ar-thralgia/osteoarthritis were assessed using the Cochrane Collaboration system .The meta-analysis was performed with RevMan 5 .3 software .Results Ten RCTs were included .Meta-analysis showed that vildagliptin had higher risk of arthralgia/osteoar-thritis than other oral hypoglycemic agents or placebo (RR=1 .24 ,95% CI 1 .08 to 1 .44 ,P=0 .003) .Further analysis indica-ted that patients received different doses of vildagliptin had higher risk of arthralgia/osteoarthritis than the placebo group (RR=1 .35 ,95% CI 1 .02 to 1 .78 ,P=0 .04) .In particular ,the group who took vildagliptin 50mg once daily had significantly higher risk of arthralgia/osteoarthritis than the placebo group (RR=3 .04 ,95% CI 1 .44 to 6 .44 ,P=0 .004) .In comparison of other oral hypoglycemic agents ,the vildagliptin group had higher risk of arthralgia /osteoarthritis (RR=1 .19 ,95% CI 1 .01 to 1 .41 ,P=0 .04) .Conclusion Based on the Meta-analysis results ,vildagliptin increases the risk of arthralgia/osteoarthri-tis .Especially vildagliptin 50mg once daily had two times higher risk than the placebo group .However the long-term safety of vidagliptin still needs to be confirmed by RCTs with larger samples and long term follow-up .