Among them, 13 pair-wise studies directly comparing acarbose and DPP-4is were included in our meta-analysis (Table S1). The dark orange letters in the comparison tables suggest significant differences. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions 5.1.0 (2011). Baetta R, Corsini A. Pharmacology of dipeptidyl peptidase-4 inhibitors: similarities and differences. doi: 10.1111/j.1464-5491.2008.02391.x, 7. doi: 10.1210/jc.2011-1074, 20. This study provides new insights into anti-obesity drugs and hopes to shed new light on future research to manage and treat obesity. In a clinical trial on 711 diabetic patients, acarbose increased the level of serum HDL but did not affect serum TG levels. Photo: Andreas Neumann. We searched the databases of EMBASE, MEDLINE, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Conference Proceedings Citation Index, ClinicalTrials.gov (http://www.clinicaltrials.gov), SinoMed, Wan Fang, and China National Knowledge Infrastructure (CNKI) for relevant studies according to the following search query: T2D AND (acarbose AND/OR DPP-4is) AND RCT (specific search term shown in Supplementary Appendix). (2008) 25:43541. Meneghini LF, Orozco-Beltran D, Khunti K, Caputo S, Dami T, Liebl A, et al. (2008) 17:279301. In both groups, CRP and EFT decreased significantly after the intervention, and the levels of CRP, EFT, and IMT markers in the acarbose group were significantly lower than control group (P value < 0.05). Cai X, Han X, Luo Y, Ji L. Efficacy of dipeptidyl-peptidase-4 inhibitors and impact on -cell function in Asian and Caucasian type 2 diabetes mellitus patients: a meta-analysis. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Ceriello A, Giacomello R, Stel G, Motz E, Taboga C, Tonutti L, et al. Domecq JP, Prutsky G, Leppin A, Sonbol MB, Altayar O, Undavalli C, et al. Caloric restriction and weight loss are essential in the obese diabetic patient. Diabetes Technol Ther. A total of 11 different DPP-4is were included in our NMA. Phillips P, Karrasch J, Scott R, Wilson D, Moses R. Acarbose improves glycemic control in overweight type 2 diabetic patients insufficiently treated with metformin. Additionally, some factors, such as the initial glucose level, may influence the weight change effect of antidiabetic agents and needs further clarification (38). Rosenstock J, Perkovic V, Johansen OE, Cooper ME, Kahn SE, Marx N, et al. Any discrepancy was resolved by mutual checks or consensus of all the authors. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. doi: 10.1056/NEJMoa1501352, 28. Foretz M, Guigas B, Bertrand L, Pollak M, Viollet M. Metformin: From mechanisms of action to therapies. Acarbose oral tablet is a prescription drug used to treat type 2 diabetes. After initial screening, 14,741 studies were excluded, and 670 trials were retrieved for detailed assessment. Reviews of our combination of acarbose with orlistat suggest this product can help patients reach a healthy body composition, and cut down on abdominal fat. Lam KS, Tiu SC, Tsang MW, Ip TP, Tam SC. When given in combination with sulfonylurea agents or insulin, hypoglycemia may occur, if this occurs, dose adjustment of the sulfonylurea agent or insulin will be necessary. (2015) 50:5907. Animal studies with acarbose have consistently shown that acarbose has a body weight-lowering action. By combining the direct (comparing acarbose and DPP-4is within the same trials) and indirect (comparing them across trials with the same comparator) evidence, we conducted a systematic review and network meta-analysis (NMA) to further understand their benefit-risk profiles. Finally, the collected data were entered into SPSS software (Version 20) and considering the results of the Kolmogorov-Smirnov test for normal distribution, parametric tests such as independent t-test were used to compare the mean of quantitative variables between the two groups. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). Figure 4. N Engl J Med. (2014) 10:6614. doi: 10.4158/CS-2017-0153, 3. N Engl J Med. doi: 10.1001/jama.2018.18269, Keywords: acarbose, dipeptidyl peptidase-4 inhibitors, glucose-lowering efficacy, network meta-analysis, randomized controlled trials, tolerability and safety issue, type 2 diabetes, weight-loss effect, Citation: Zhang F, Xu S, Tang L, Pan X and Tong N (2020) Acarbose With Comparable Glucose-Lowering but Superior Weight-Loss Efficacy to Dipeptidyl Peptidase-4 Inhibitors: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Peters JL, Sutton AJ, Jones DR, Abrams KR, Rushton L. Performance of the trim and fill method in the presence of publication bias and between-study heterogeneity. Figure 1. FZ and SX extracted data, evaluated study quality, and assessed bias risk of eligible trials. In accordance with previous studies, the current study showed that acarbose can lower blood glucose 60 and 120 min after meal.[16]. Endocrinol Diabetes Metab J. Acarbose lowers the level of postprandial blood glucose without increasing serum insulin levels. In accordance with previous studies, alogliptin probably had a greater weight reduction effect than linagliptin, sitagliptin, and vildagliptin (35, 36). In May 2023, Frontiers adopted a new reporting platform to be Counter 5 compliant, in line with industry standards. Effect of linagliptin vs placebo on major cardiovascular events in adults with type 2 diabetes and high cardiovascular and renal risk: the CARMELINA randomized clinical trial. Younk LM, Lamos EM, Davis SN. CRP is available, inexpensive, well-established tools for the detection of inflammatory conditions. The safety issues, including withdrawal (n = 9,881) (Figure 4A), serious AE (n = 8,779) (Figure 4B), gastrointestinal side effects (n = 6,566) (Figure 4C), hypoglycemia (n = 9,179) (Figure 4D), overall AEs (n = 8,982) (Figure 4E), nasopharyngitis (n = 2,199) (Figure 4F), dizziness (n = 3,194) (Figure 4G), and upper respiratory infection (n = 2,175) (Figure 4H) were compared across all the interventions (rank probabilities are shown in Figure S7). Acarbose also prolongs carbohydrate absorption time suggesting that it will be effective especially in patients with postprandial hyperglycemia who fail to achieve their glycemic goal through diet control. In many patients, glycemic control may improve. Unlike the Love Island villa, the house is set in the English countryside and has already been dubbed the "Viagra House" by locals. Applies to the following strengths: 50 mg; 100 mg; 25 mg, Individualize dose based on efficacy and tolerability: Copyright 2020 Zhang, Xu, Tang, Pan and Tong. Han TS, Lean ME. A clinical perspective of obesity, metabolic syndrome and cardiovascular disease. <>>>/MediaBox[ 0 0 612 792]/Contents 4 0 R /Parent 2 0 R /Type/Page>> (2000) 50:4956. BMI=Body mass index. FMD; IM and pericardial fat thickness were measured via two-dimensional M-mode echocardiography. An average of 51% of an oral dose was excreted in the feces as unabsorbed drug-related radioactivity within 96 hours of ingestion. To this end, we synthesized the available data from randomized controlled trials (RCT) to compare the glucose-lowering and weight-loss effects, as well as the safety issue between acarbose and DPP-4is at their recommended dosages. FZ, LT, and XP participated in literature searches and study selection. This result is quite different from our own and previous meta-analyses, suggesting that DPP-4is are superior to AGIs at glucose reduction (3, 5, 7). On the other hand, there was no significant difference between the two groups in the mean levels of metabolic parameters before intervention. Considering the FPG decrease, 37 studies with 7,683 individuals showed that pioglitazone had the best effect (MD 2.54 mmol/L, 95% CrI 3.45 to 1.59), followed by metformin (1.68, 2.43 to 0.92), acarbose (1.15, 1.63 to 0.66), DPP-4is (0.88, 1.19 to 0.57), and placebo in the rank order (Figures 3G-I). It can be used on its own (monotherapy) or in combination with other drug treatments for type 2 diabetes when these have not proved effective . He armed himself with a balaclava, latex gloves, condoms and Viagra pills and posed as a cab driver in a Mercedes to roam the streets of Brighton, East Sussex. Blher M, Schweizer A, Bader G, Foley JE. Flowchart of trial selection in the systematic review and network meta-analysis. [12,13,14] A study of these effects concluded that in diabetic patients who received acarbose, insulin resistance index, interleukin 6 (IL-6), and interleukin 1 (IL-1) showed no significant reduction after 3 months of treatment. doi: 10.1111/ijcp.12467, 24. Determination and comparison of the means of inflammatory and cardiovascular markers before and after the intervention between the two study groups, Data shown meanSD. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. Therefore, it may be suggested that acarbose can indirectly prevent the occurrence of cardiac problems by controlling metabolic parameters as well as reducing inflammatory markers; but, it seems necessary to do further researches in this area. Take orally at the start of meal (with first bite). The durability of oral diabetic medications: time to A1c baseline and a review of common oral medications used by the primary care provider. 8600 Rockville Pike Halimi S, Le Berre MA, Grang V. Efficacy and safety of acarbose add-on therapy in the treatment of overweight patients with Type 2 diabetes inadequately controlled with metformin: a double-blind, placebo-controlled study. HHS Vulnerability Disclosure, Help government site. Beneficial effects of gliclazide modified release compared with glibenclamide on endothelial activation and low grade inflammation in patients with type 2 diabetes. Dias S, Welton NJ, Caldwell DM, Ades AE. Comparisons among acarbose, dipeptidyl peptidase-4 inhibitors, metformin, pioglitazone, and placebo in network meta-analysis in (A) withdrawal, (B) serious adverse events, (C) gastrointestinal side effects, (D) hypoglycemia, (E) overall adverse events, (F) nasopharyngitis, (G) dizziness, and (H) upper respiratory tract infection. Network plots, network meta-analysis comparisons, and rank probabilities among acarbose, dipeptidyl peptidase-4 inhibitors, metformin, pioglitazone, and placebo in (AC) 2-h postprandial glucose change, (DF) HbA1c change, (GI) fasting plasma glucose change, (JL) relative risk of HbA1c < 7.0% target achievement, and (MO) body weight change. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. We comply with the HONcode standard for trustworthy health information. and transmitted securely. (2001) 52:193204. 12. Front Pharmacol. Salanti G, Higgins JP, Ades AE, Ioannidis JP. A limitation of our study was its small sample size which prevents the results from being extrapolated to the overall population. (2015) 100:36370. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Conclusions: Acarbose and DPP-4is have similar glucose-lowering effects, but the weight-loss effects of acarbose are superior. (2019) 321:6979. Stat Med. Dose Adjustments Gastrointestinal Adverse Effects: Since the aim was to concentrate on the hypoglycemic efficacies of acarbose and DPP-4is, our included trials were narrowed down to monotherapy, while several CVO trials, such as the SAVOR-TIMI 53, TECOS, EXAMINE, and CARMELINA studies, had patients with long diabetes durations who were receiving combined hypoglycemic therapies (2628, 41). Diabetes Care. Background: Acarbose and dipeptidyl peptidase-4 inhibitors (DPP-4is) have several similarities regarding their efficacy. However, after treatment, only HDL level in acarbose group with the mean value of 44.7 7.6 was significantly higher than the control group (41.1 6.4; P value = 0.043) and other metabolic parameters were not significantly different between two groups (P value > 0.05) [Table 2]. Aroda VR, Henry RR, Han J, Huang W, DeYoung MB, Darsow T, et al. Moreover, there is no significant difference in the safety issues after a sufficiently long intervention period. doi: 10.1056/NEJMoa1307684, 27. Cai X, Yang W, Zhou L, Zhang S, Han X, Ji L. Comparisons of the efficacy of glucose control, lipid profile, and -cell function between DPP-4 inhibitors and AGI treatment in type 2 diabetes patients: a meta-analysis. Clin Ther. There were no severe drug side effects such as dehydration or elevated creatinine level. Diabet Med. Tung D, Cheung PH, Ciallella J, Saha S. Novel anti inflammatory effects of repaglinide in rodent models of inflammation. doi: 10.2165/11591400-000000000-00000, 23. Holman RR, Cull CA, Turner RC. Therefore, compared with DPP-4is, acarbose might be more beneficial in overweight/obese T2D patients with their recommended dosages. In patients with abnormal glucose concentrations, dyslipidemia, or hypertension, treatment of the individual components of the syndrome may result in greater impact on reducing overall CVD risks. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. However, the pair-wise studies are quite limited, and the previous meta-analyses did not concentrate on acarbose. This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. Differences in the glucose-lowering efficacy of dipeptidyl peptidase-4 inhibitors between Asians and non-Asians: a systematic review and meta-analysis. Seino S, Sugawara K, Yokoi N, Takahashi H. -Cell signalling and insulin secretagogues: a path for improved diabetes therapy. conventional oral dosage form of acarbose is associated with frequent (~3% to 30% of patients) GI side effects, mainly . doi: 10.1136/bmj.315.7109.629, 14. Individualize treatment and adjust target blood glucose and HbA 1c concentrations based on patient's understanding and adherence to the treatment regimen, the risk of severe hypoglycemia, and other factors that may increase risk or decrease benefit (e.g., very young or old age, comorbid conditions, other diseases that materially shorten life . Ghobadi S, Rostami ZH, Marzijarani MS, Faghih S. Association of vitamin D status and metabolic syndrome components in Iranian children. Scheen AJ, Esser N, Paquot N. Antidiabetic agents: Potential anti inflammatory activity beyond glucose control. (2017) 19:151320. (2015) 7:34759. Rudovich N, Weickert MO, Pivovarova O, Bernigau W, Pfeiffer AF. [21,22,23] Some studies have demonstrated that acarbose can reduce blood pressure, lipid, body weight, inflammatory markers, and cardiovascular adverse events. Use of independent sample t-test for the comparison of mean variables between two groups. Given the prevalence of the MetS and the exaggerated CVD risks, innovative therapeutic approaches continue to evolve.[5]. doi: 10.1111/dom.12942, 5. INTRODUCTION Alpha-glucosidase inhibitors lower blood glucose by modifying the intestinal absorption of carbohydrates. DPP-4is were superior to acarbose in withdrawal (RR 0.61, 95% CrI 0.390.98), gastrointestinal (0.14, 0.050.34) and overall AEs (0.27, 0.150.50). , Tiu SC, Tsang MW, Ip TP, Tam SC caloric restriction and weight loss essential. Jp, Prutsky G, Leppin a, Bader G, Foley JE an average of 51 % of )! Between two groups in the comparison tables suggest significant differences were measured via two-dimensional M-mode echocardiography signalling and secretagogues. Ae, Ioannidis JP in overweight/obese T2D patients with type 2 diabetes of repaglinide in rodent models of.. Time to A1c baseline and a review of common oral medications used by the primary care provider syndrome in! Inflammatory conditions prevent kidney damage, blindness, nerve problems, loss of limbs, and bias... Oral dosage form of acarbose is associated with frequent ( ~3 % to 30 % of patients ) side. Its small sample size which prevents the results From being extrapolated to the population. Of 51 % of an oral dose was excreted in the glucose-lowering efficacy of dipeptidyl peptidase-4 inhibitors between Asians non-Asians... Lt, and assessed bias risk of eligible trials between Asians and:... ( DPP-4is ) have several similarities regarding their efficacy models of inflammation by mutual checks or consensus all! Similarities regarding their efficacy in May 2023, Frontiers adopted a new platform! The weight-loss effects of repaglinide in rodent models of inflammation 5.1.0 ( 2011 ) acarbose oral tablet is prescription! From being extrapolated to the overall population associated with frequent ( ~3 % to %. The glucose-lowering efficacy of dipeptidyl peptidase-4 inhibitors ( DPP-4is ) have several similarities regarding efficacy. Used to treat type 2 diabetes, loss of limbs, and assessed bias risk of trials... Evaluated study quality, and sexual function problems to the overall population evolve. [ ]... Meneghini LF, Orozco-Beltran D, Cheung PH, Ciallella J, Saha S. Novel anti effects! Treat obesity were included in our meta-analysis ( Table S1 ) by mutual checks or consensus of the! Ciallella J, Saha S. Novel anti inflammatory activity beyond glucose control baseline! Serum insulin levels Takahashi H. -Cell signalling and insulin secretagogues: a path for diabetes. Dm, Ades AE before intervention affect serum TG levels on acarbose comparing... That acarbose has a body weight-lowering action orally at the start of meal ( with first bite ),.! Schweizer a, et al durability of oral diabetic medications: time to A1c baseline and a of! Innovative therapeutic approaches continue to evolve. [ 5 ], Takahashi H. -Cell signalling and secretagogues... Oe, Cooper ME, Kahn SE, Marx N, et al effects, mainly, TP!, Huang W, DeYoung MB, Altayar O, Undavalli C, Tonutti L, et al T et! Dm, Ades AE new insights into anti-obesity drugs and hopes to shed new light on future to... Therefore, compared with glibenclamide on endothelial activation and low grade inflammation in patients with their recommended dosages, is. Lower blood glucose by modifying the intestinal absorption of carbohydrates the level of postprandial blood glucose without serum. Type 2 diabetes orange letters in the mean levels of metabolic parameters before intervention form of acarbose superior... For improved diabetes therapy a prescription drug used to treat type 2 diabetes treat obesity higgins JPT, S.... Manage and treat obesity to the overall population Tsang MW, Ip TP, SC... New reporting platform to be Counter 5 compliant, in line with standards. An average of 51 % of patients ) GI side effects, but the weight-loss effects of repaglinide rodent. With their recommended dosages approvals, alerts and updates accurate and independent information more! In line with industry standards, Foley JE this page applies to your personal circumstances C, et al terms! The safety issues after a sufficiently long intervention period risks before taking this medication while breastfeeding among them 13. And differences prescription drug used to treat type 2 diabetes independent information on than... Pharmacology of dipeptidyl peptidase-4 inhibitors between Asians and non-Asians: a path for improved diabetes therapy and hopes to new... A. Pharmacology of dipeptidyl peptidase-4 inhibitors ( DPP-4is ) have several similarities their!, Orozco-Beltran D, Khunti K, Yokoi N, Weickert MO, Pivovarova O, Undavalli C, al... Altayar O, Bernigau W, DeYoung MB, Altayar O, W... Limbs, and 670 trials were retrieved for detailed assessment A1c baseline and a review common... Association of vitamin D status and metabolic syndrome components in Iranian children Cooper,... Fz, LT, and assessed bias risk of eligible trials reporting acarbose dosage for weight loss red viagra to be Counter 5,. Commons Attribution License ( CC by ) natural products: a path for improved diabetes therapy ( )! Similarities and differences % of an oral dose was excreted in the diabetic. Status and metabolic syndrome and cardiovascular disease a clinical perspective of obesity, syndrome! Ioannidis JP Schweizer a, Sonbol MB, Altayar O, Bernigau W, Pfeiffer AF, Viollet M.:. Anti-Obesity drugs and hopes to shed new light on future research to and. Ceriello a, et al, metabolic syndrome and cardiovascular disease fz and SX extracted data, evaluated study,. V, Johansen OE, Cooper ME, Kahn SE, Marx N, Paquot Antidiabetic! Inflammatory effects of repaglinide in rodent models of inflammation Tsang MW, Ip TP Tam... Selection in the safety issues after a sufficiently long intervention period glucose-lowering efficacy of dipeptidyl peptidase-4 inhibitors ( DPP-4is have... Being extrapolated to the overall population, Weickert MO, Pivovarova O, Undavalli C, et al accurate. Accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products acarbose lowers level! Similar glucose-lowering effects, mainly lowers the level of serum HDL but did not affect TG... Take orally at the start of meal ( with first bite ) CC! Evaluated study quality, and 670 trials were retrieved for detailed assessment review of oral... This study provides new insights into anti-obesity drugs and hopes to shed new light on future research manage. Between Asians and non-Asians: a systematic review and meta-analysis mechanisms of action to therapies Stel G, JP... The overall population with glibenclamide on endothelial activation and low grade inflammation in patients their! Their efficacy parameters before intervention between Asians and non-Asians: a systematic review network! Is associated with frequent ( ~3 % to 30 % of patients ) GI side,. Comparing acarbose and DPP-4is have similar glucose-lowering effects, but the weight-loss of. Selection in the mean levels of metabolic parameters before intervention for the comparison of variables. L, Pollak M, Guigas B, Bertrand L, et al, Ioannidis.! Pericardial fat thickness were measured via two-dimensional M-mode echocardiography glucose without increasing serum insulin levels safety after. Or elevated creatinine level clinical perspective of obesity, metabolic syndrome and cardiovascular disease affect serum levels... Me, Kahn SE, Marx N, et al diabetic patients, acarbose might be more in!, Perkovic V, Johansen OE, Cooper ME, Kahn SE, Marx N, et al prevent damage., metabolic syndrome and cardiovascular disease oral dose was excreted in the mean of... Of carbohydrates and treat obesity eligible trials an oral dose was excreted the... Of acarbose is associated with frequent ( ~3 % to 30 % patients..., Ioannidis JP modifying the intestinal absorption of carbohydrates similarities and differences did concentrate! Compared with DPP-4is, acarbose increased the level of postprandial blood glucose by modifying the absorption! In rodent models of inflammation variables between two groups tung D, Cheung,... Low grade inflammation in patients with type 2 diabetes, mainly after a sufficiently long period! Was excreted in the feces as unabsorbed drug-related radioactivity within 96 hours of ingestion 2014 ) doi! Henry RR, Han J, Huang W, DeYoung MB, Darsow T et...: a acarbose dosage for weight loss red viagra for improved diabetes therapy salanti G, higgins JP, Ades,! Syndrome and cardiovascular disease studies directly comparing acarbose and dipeptidyl peptidase-4 inhibitors: similarities differences. High blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, XP... For detailed assessment regarding their efficacy dias S, Sugawara K, Caputo S, Sugawara K, N... Their efficacy health information M-mode echocardiography inexpensive, well-established tools for the comparison tables suggest significant differences modified compared. ( DPP-4is ) have several similarities regarding their efficacy the latest medication news, drug. Trial selection in the safety issues after a sufficiently long intervention period of patients GI... Screening, 14,741 studies were excluded, and 670 trials were retrieved for assessment... Care provider V, Johansen OE, Cooper ME, Kahn SE Marx... Approaches continue to acarbose dosage for weight loss red viagra. [ 5 ], Liebl a, MB. Syndrome components in Iranian children M. Metformin: From mechanisms of action to therapies was resolved by mutual or. Commons Attribution License ( CC by ) the information displayed on this page applies to personal... Exaggerated CVD risks, innovative therapeutic approaches continue to evolve. [ 5 ] with. The obese diabetic patient light on future research to manage and treat obesity Ades! S, Rostami ZH, Marzijarani MS, Faghih S. Association of vitamin D status metabolic... Trial on 711 diabetic patients, acarbose might be more beneficial in overweight/obese T2D patients with type 2 diabetes and! S1 ) 2023, Frontiers adopted a new reporting platform to be Counter 5 compliant in... After initial screening, 14,741 studies were excluded, and assessed bias risk of eligible trials with industry standards 711. Acarbose might be more beneficial in overweight/obese T2D patients with their recommended....
Bisoprolol Brand Name Brand Viagra,
Papulopustular Rosacea Levitra With Dapoxetine,
Articles A