首页|GLP-1受体激动剂致2型糖尿病患者胃肠道不良反应的网状Meta分析

GLP-1受体激动剂致2型糖尿病患者胃肠道不良反应的网状Meta分析

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目的 评价胰高血糖素样肽-1受体激动剂(GLP-1RA)对2型糖尿病(T2DM)患者胃肠道反应的影响。方法 系统检索PubMed、Embase和Cochrane Library等数据库中自建库起至2023年10月1日GLP-1RA治疗T2DM的随机对照试验，试验组药物为一种GLP-1RA，对照组药物为安慰剂或另一种GLP-1RA。采用贝叶斯网状荟萃分析方法，探讨各GLP-1RA胃肠道不良反应发生风险，如恶心、呕吐、食欲减退、便秘、消化不良、腹泻等。结果 共纳入文献45篇，涉及患者27 729例。GLP-1RA引起胃肠道不良反应的总发生率为11。66％。与安慰剂相比，替尔泊肽引发恶心、腹泻、消化不良、食欲减退的风险最高，利司那肽引发呕吐的风险最高，司美格鲁肽引发便秘的风险最高。与安慰剂相比，除洛塞那肽外，其余GLP-1RA均显著增加呕吐的风险;除利司那肽外，其余GLP-1RA均显著增加腹泻的风险;除替尔泊肽、利司那肽外，其余GLP-1RA均显著增加便秘的风险;所有GLP-1RA均能显著降低食欲及增加消化不良的风险(P＜0。05)。结论 GLP-1RA可增加T2DM患者发生胃肠道不良反应的风险，不同GLP-1RA引发各症状的风险不同，其中替尔泊肽引发消化道症状的风险较高，值得临床关注与警惕。
GLP-1 receptor agonists cause gastrointestinal adverse reaction in patients with type 2 diabetes mellitus:a network meta-analysis
AIM To evaluate the effects of glucagon-like peptide-1 receptor agonists(GLP-1RA)on gastrointestinal adverse reactions in patients with type 2 diabetes mellitus(T2DM).METHODS The databases PubMed,Embase,and Cochrane Library were systematic searched for randomized controlled trials of GLP-1RA for the treatment of T2DM from the time of construction until October 1st,2023,with one GLP-1RA as the drug in the trial arm and placebo or another GLP-1RA as the drug in the control arm.Bayesian network meta-analysis was used to explore the risk of gastrointestinal adverse reactions,such as nausea,vomiting,anorexia,constipation,dyspepsia,and diarrhea.RESULTS Forty-five papers were included,involving 27 729 patients.The overall incidence of gastrointestinal adverse reactions caused by GLP-RA was 11.66％.Compared with placebo,tirzepatide caused the highest risk of nausea,diarrhea,dyspepsia,and anorexia,lixisenatide caused the highest risk of vomiting,and semaglutide caused the highest risk of constipation.Compared with placebo,all GLP-1RA except loxenatide significantly increased the risk of vomiting;all GLP-1RA except lixisenatide significantly increased the risk of diarrhea;all GLP-1RA significantly increased the risk of constipation except tirzepatide and lixisenatide;all GLP-1RA significantly decreased appetite and increased the risk of dyspepsia(P＜0.05).CONCLUSION GLP-1RA significantly increased the risk of gastrointestinal adverse reactions in T2DM patients,and different drugs have different risks of various symptoms,among which tirzepatide has a higher risk of gastrointestinal symptoms,which deserves clinical attention and vigilance.

glucagon-like peptide-1 receptordiabetes mellitus,type 2meta-analysisgastrointestinal adverse reactions

郑彩云、林妹妹、戴亨纷

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福建医科大学附属福清市医院,福建福州 350300

福建医科大学附属福州市第一医院,福建福州 350009

胰高血糖素样肽-1受体 糖尿病,2型 Meta分析 胃肠道不良反应

福建医科大学启航基金福建医科大学启航基金福州市卫生健康科技计划项目福州市卫生健康科技计划项目福建省自然科学基金福建医科大学附属福州市第一医院院级科研项目

2020QH13462020QH13452022-S-wq12022-S-wr22021J0113042022-YJ-02

2024

10.14109/j.cnki.xyylc.2024.06.13

中国新药与临床杂志
中国药学会 上海市食品药品监督管理局科技情报研究所

中国新药与临床杂志

CSTPCD北大核心
影响因子：0.967
ISSN：1007-7669
年,卷(期)：2024.43(6)
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