Efficacy and hypoglycemic risk of sitagliptin in obese/overweight patients with type 2 diabetes compared with GLP-1 receptor agonists: A meta-analysis.

OBJECTIVE: The purpose of this study was to assess the efficacy and hypoglycemic risk of sitagliptin versus that of GLP-1 receptor agonists in the management of obese/overweight patients with T2DM. METHODS: EMBASE, PubMed, Cochrane Library, and ClinicalTrials.gov were searched; randomized controlled trials comparing the efficacy of sitagliptin versus that of GLP-1 receptor agonists in obese/overweight patients with T2DM were included. The mean BMI of participants for each study was ≥30 kg/m. We conducted a meta-analysis according to the methods specified in the Cochrane Handbook for Systematic Reviews of Interventions. RevMan 5.1 software was used to perform the meta-analysis. The Cochrane Q test and I statistics were used to estimate the heterogeneity among studies. The results are expressed as the mean difference (MD) or risk ratio (RR) with 95% confidence intervals. RESULTS: A total of 8 eligible studies were included in our meta-analysis. Compared with GLP-1 receptor agonists, sitagliptin was less effective at reducing HbA1c (0.42 [0.27, 0.56]), FPG (0.78 [0.36, 1.19]), PPG (2.61 [1.35, 3.87]), and body weight (1.42 [0.71, 2.14]). Conversely, there were no significant differences in SBP reduction (0.38 [-1.14, 1.89]), DBP reduction (-0.30 [-1.00, 0.39]), and hypoglycemic risk (1.09 [0.50, 2.35]). CONCLUSION: For obese/overweight patients, sitagliptin may exert a less potent effect on HbA1C, FPG, PPG, and weight reduction than GLP-1 receptor agonists, but these drugs had a similar efficacy in reducing blood pressure; furthermore, there was no significant difference in hypoglycemic risk.

The risk factors of linezolid-induced lactic acidosis: A case report and review.

BACKGROUND: In recent years, linezolid is increasingly used in multidrug-resistant bacteria therapy. At the same time, linezolid-induced lactic acidosis has been continually reported as a serious side effect. Notably, to our knowledge, there are limited available literatures that evaluate risk factors for linezolid-induced lactic acidosis, and there is no highly reliable study on the relationship between linezolid-induced lactic acidosis and age or gender. However, clinicians need relevant information to advice on the use of linezolid. Therefore, we report on a case of life-threatening lactic acidosis after 3 doses of linezolid exposure and evaluate the risk factors of linezolid-induced lactic acidosis. METHODS: Cases of linezolid-induced lactic acidosis reported in PubMed were searched. Several characteristics and data of case numbers and deaths were extracted for analysis. RESULTS: A total of 35 articles including 47 cases were included in this study. Twelve patients (25.5%) died due to linezolid-induced lactic acidosis. At the cut-offs of 7, 14, and 28 days, the mortalities were 27.3%, 20%, and 27.3%. No statistically significant difference was observed according to age and gender. However, the proportion (27.7% and 29.8%) and mortality (30.8% and 35.7%) of male patients were much higher than females in both ≥65 and <65 years old groups (proportion: 15.2% and 23.9%; mortality: 14.3% and 18.2%). CONCLUSION: The mortality of linezolid-induced lactic acidosis was relatively high. The duration of linezolid use and age might not be risk factors. Gender (specifically, male) might be related to the mortality of linezolid-induced lactic acidosis.

The efficacy of mycophenolate mofetil in treating Takayasu arteritis: a systematic review and meta-analysis.

The purpose of this study is to assess the effectiveness of mycophenolate mofetil (MMF) in treating Takayasu arteritis (TA) patients. Embase, Cochrane Library, Pubmed, Clinicaltrials. Gov and three Chinese literature databases (VIP, CNKI, WanFang) were searched; randomized-controlled trials and observational studies that compared the efficacy before and after treatment with MMF were included. The efficacy outcomes were disease activity, the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) values and steroid dosage. The results were expressed as mean differences with 95% confidence intervals. Compared with the baseline, there were significant reductions in the ESR (-14.92 [25.35, -4.48]), CRP values (-12.99 [-23.29, -2.68]) and the steroid dosage (-17.64 [-24.89, -10.4]) after the addition of MMF, and the disease tended to stabilize. Therefore, MMF might be an alternative immunosuppressive drug for TA for the control of disease activity and to taper the steroid dosage.