Meta-analysis on safety of repaglinide versus nateglinide in the treatment of type 2 diabetes

WEI Jin-fei; ZHOU Liang; ZHANG Ke; ZHANG Xin; LIU Gui-yang; WANG Xin-hu

Abstract：[ABSTRACT]Objective:To systematically evaluate the safety of repaglinide versus nateglinide in the treatment of type 2 diabetes.Methods:PubMed, Medline, Cochrane, EMbase, CNKI, VIP and Wanfang databases were retrieved. Literature were selected and assessed according to the inclusion criteria. The meta-analysis was performed by RevMan 5.2 software.Results:Ten studies were included ultimately, with total of 2300 patients (1150 patients receiving repaglinide and 1150 patients receiving nateglinide). The meta-analysis revealed the following results: repaglinide group was better than nateglinide group in reducing the levels of HbA1c [MD =–0.23, 95%CI (–0.34,–0.12),P < 0.000 1] and FPG [MD =–0.16, 95%CI (–0.24,–0.07),P = 0.000 3]. There was no signiifcant difference between two groups in reducing the level of PPG [MD = 0.10, 95%CI (–0.29, 0.48),P = 0.63]. The occurrence risks of hypoglycemia [OR = 1.92, 95%CI (1.16, 3.20),P = 0.01] and gastrointestinal reactions [OR = 2.64, 95%CI (1.09, 6.39),P= 0.03] were higher in repaglinide group than nateglinide group. While the occurrence risks of hepatic dysfunction [OR = 3.02, 95%CI (0.61, 15.01),P = 0.18], anaphylaxis [OR = 0.28, 95%CI (0.06, 1.36),P = 0.12] and cardiovascular system [OR = 0.60, 95%CI (0.22, 1.65),P = 0.32] were similar between two groups.Conclusion:Repaglinide was more effective in reducing blood sugar than that of nateglinide in the treatment of type 2 diabetes, while the occurrence risks of hypoglycemia and gastrointestinal reactions were relatively higher. Further multicenter, large samples, high quality RCTs are warranted to verify the results of this article because of the drawbacks of experimental design.