國家衛生研究院 NHRI:Item 3990099045/16040
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    題名: Evaluation of glucose-lowering medications in older people: A comprehensive systematic review and network meta-analysis of randomized controlled trials
    作者: Pan, SY;Su, EL;Huang, CJ;Chuang, SY;Chiang, CE;Chen, CH;Cheng, HM
    貢獻者: Institute of Population Health Sciences
    摘要: Background Type 2 diabetes mellitus (T2DM) is increasingly being diagnosed in older adults. Our objective is to assess the advantages and potential drawbacks of different glucose-lowering medications in this specific population.Methods A network meta-analysis was conducted to identify randomized controlled trials that examined patient-centered outcomes in adults aged >= 65 years with T2DM. We searched PubMed, Cochrane CENTRAL, and Embase up to September 23, 2023. Quality of eligible studies were assessed using the Cochrane RoB 2.0 tool.Results A total of 22 trials that involved 41 654 participants were included, incorporating sodium-glucose cotransporter-2 (SGLT2) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs), dipeptidyl peptidase-4 (DPP-4) inhibitors, metformin, sulfonylureas (SU) and acarbose. Our findings reveal that GLP-1RAs reduce the risk of major adverse cardiovascular events (risk ratio [RR], 0.83; 95% confidence interval [CI], 0.71 to 0.97) and body weight (mean difference [MD], -3.87 kg; 95% CI, -5.54 to -2.21). SGLT2 inhibitors prevent hospitalization for heart failure (RR, 0.66; 95% CI, 0.57 to 0.77), renal composite outcome (RR, 0.69; 95% CI, 0.53 to 0.89), and reduce body weights (MD, -1.85 kg; 95% CI, -2.42 to -1.27). SU treatment increases the risk of any hypoglycaemia (RR, 4.19; 95% CI, 3.52 to 4.99) and severe hypoglycaemia (RR, 7.06; 95% CI, 3.03 to 16.43). GLP-1RAs, SGLT2 inhibitors, metformin, SU and DPP-4 inhibitors are effective in reducing glycaemic parameters. Notably, the number of treatments needed decreases in most cases as age increases.Conclusions Novel glucose-lowering medications with benefits that outweigh risks should be prioritized for older patients with diabetes. Graphical Abstract
    日期: 2024-08-13
    關聯: Age and Ageing. 2024 Aug 13;53(8):Article number afae175.
    Link to: http://dx.doi.org/10.1093/ageing/afae175
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0002-0729&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:001289551400001
    Cited Times(Scopus): https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85201249493
    顯示於類別:[莊紹源] 期刊論文

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