Ertugliflozin多剂量治疗2型糖尿病的有效性和安全性的网状meta分析
A network meta-analysis of efficacy and safety of multiple-dose of ertugliflozin in patients with type 2 diabetes

摘要：目的 采用网状meta分析方法评价ertugliflozin多剂量治疗2型糖尿病(T2DM)的疗效和安全。方法 计算机检索Cochrane图书馆、Embase、 PubMed、OVID、Web of Science、中国知网、维普和万方数据库，按Cochrane系统评价的方法评价纳入研究的质量，使用Review Manager 5.3、R软件和Stata 14.0软件进行分析。结果 共纳入4个随机对照试验(RCTs)，1433例患者，网状meta分析结果显示：ertugliflozin 5、10、15、25mg在降低糖化血红蛋白(HbA1c)方面均优于安慰剂组，且具有统计学意义，在等级概率图中，ertugliflozin 15mg排名第一；ertugliflozin 5、10、15、25mg都能降低空腹血糖(FPG)，且具有统计学意义，ertugliflozin 10mg在等级概率图中排名第一；ertugliflozin 5、10、15、25mg能降低患者体质量，均具有统计学意义，且ertugliflozin 10mg在等级概率图中排名第一。在总不良反应和低血糖发生率方面，ertugliflozin 10mg和15mg最低；而在患者因不良反应退出发生率方面，ertugliflozin 5mg和10mg的发生率最低。结论 ertugliflozin的不同剂量组治疗T2DM的有效性显著、安全性一般，但由于纳入文献较少，仍需更多大样本、多中心的高质量文献进行验证。
ABSTRACT: Objective To evaluate the efficacy and safety of mutiple-dose of ertugliflozin in the treatment of type 2 diabetes mellitus (T2DM) with network meta-analysis. Methods The databases of Cochrane Library, Embase, PubMed, OVID, Web of Science, CNKI, VIP and Wanfang were retrieved with the computer. The reviewers assessed the quality of the literature according to the Cochrane Handbook, and made the analysis using Review Manager 5.3, R software and Stata 14.0 software. Results Four randomized controlled trials (RCTs) involving 1433 patients were included. The results of network meta-analysis showed that ertugliflozin of 5mg, ？？10mg？？, 15mg and 25mg significantly reduced HbA1c when compared with placebo; ertugliflozin of 15mg ranked the first in the rank probability diagram. In the respect of FPG, ertugliflozin of 5mg, 10mg, 15mg and 25mg significantly reduced FPG when compared with placebo, and ertugliflozin of 10mg ranked the first in the rank probability diagram. Ertugliflozin of 5mg, 10mg, 15mg and 25mg significantly reduced body weight when compared with placebo, and ertugliflozin of 10mg ranked the first in the rank probability diagram. Ertugliflozin of 10mg and 15mg groups had the lowest incidence of total adverse reactions and incidence of hypoglycemia, while the incidence in ertugliflozin of 5mg and 10mg groups was the lowest in patients due to the withdrawal rate of adverse reactions. Conclusion The different dosage groups of ertugliflozin had average efficacy and safety in treating with T2DM. However, due to the small sample size of the studies included, it is necessary to develop larger samples and high-quality literature for more comprehensive verification