title: Dapagliflozin treatment for type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Type 2 diabetes has reached epidemic proportions and places a heavy burden on society. Dapagliflozin is a novel treatment choice for type 2 diabetes.
  
  
  OBJECTIVE
  A meta-analysis of randomized controlled trials (RCTs) was conducted to assess the efficacy and safety of dapagliflozin treatment.
  
  
  METHODS
  Medline (via PubMed), Embase (via OVID) and the Cochrane Library (up to August 2012) were searched, and RCTs were collected.
  
  
  METHODS
  Studies included type 2 diabetic subjects, who had been treated with dapagliflozin, and recorded HbA1c as outcomes.
  
  
  METHODS
  Two reviewers independently assessed articles and study quality. Patient characteristics, interventions and outcomes were collected.
  
  
  RESULTS
  Ten RCTs were included. Risk of bias for outcomes was low. Fixed or random effects models were used to pool the results. Dapagliflozin treatment was associated with a reduction in HbA1c [weighted mean difference (WMD): -0.53%; 95% confidence interval (CI): -0.58% to -0.47%; p < 0.00001], fasting plasma glucose (WMD: -1.06 mmol/L; 95% CI: -1.20, -0.92; p < 0.00001), and body weight (WMD: -1.63 kg; 95% CI: -1.83, -1.43; p < 0.00001). Dapagliflozin monotherapy did not lead to hypoglycaemia [relative risk (RR): 1.44; 95% CI: 0. 86, 2.41; p = 0.17], although hypoglycaemic risk increased (RR: 1.16; 95% CI: 1.05, 1.29; p = 0.005) when dapagliflozin was combined with other hypoglycaemic drugs. Dapagliflozin increased urinary glucose excretion (WMD: 26.98; 95% CI: 21.72, 32.24; p < 0.00001) and was associated with an increased risk of urinary tract infections (RR: 1.33; 95% CI: 1.10, 1.60; p = 0.004) and genital tract infections (RR: 3.23; 95% CI: 2.50, 4.18; p = 0.00001).
  
  
  CONCLUSIONS
  Dapagliflozin appears to be an effective treatment for type 2 diabetes, although it may increase the risk of urinary tract infections and genital tract infections.
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Zhang
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
authors.forename: Bin
authors.initials: B
authors.lastname: Wu
authors.forename: Haolan
authors.initials: H
authors.lastname: Song
authors.forename: Zhenmei
authors.initials: Z
authors.lastname: An
authors.forename: Shuangqing
authors.initials: S
authors.lastname: Li
mesh_terms: D001559:Benzhydryl Compounds; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005960:Glucosides / Q000627:therapeutic use*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
chemical_list: D001559:Benzhydryl Compounds; D005960:Glucosides; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C529054:dapagliflozin
keywords: dapagliflozin; meta analysis; type 2 diabetes