title: Incretin-based medications for type 2 diabetes: an overview of reviews.
abstract: OBJECTIVE
  To summarize evidence from and assess the quality of published systematic reviews evaluating the safety, efficacy and effectiveness of incretin-based medications used in the treatment of type 2 diabetes.
  
  
  METHODS
  We identified systematic reviews of randomized controlled trials or observational studies published in any language that evaluated the safety and/or effectiveness of glucagon-like peptide-1 (GLP-1) receptor agonists or dipeptidyl-peptidase-4 (DPP-4) inhibitors. Data sources used include the Cochrane Library, PubMed, EMBASE, Web of Science, International Pharmaceutical Abstracts, table of contents of diabetes journals, and hand-searching of reference lists and clinical practice guidelines. The methodological quality of systematic reviews was independently assessed by two reviewers using the Assessment of Multiple Systematic Reviews (AMSTAR) checklist. Our study protocol was registered with PROSPERO (2013:CRD42013005149). The primary outcomes were pooled treatment effect estimates for glycaemic control, macrovascular and microvascular complications, and hypoglycaemic events.
  
  
  RESULTS
  We identified 467 unique citations of which 84 systematic reviews met our inclusion criteria. There were 51 reviews that evaluated GLP-1 receptor agonists and 64 reviews that evaluated DPP-4 inhibitors. The median (interquartile range) AMSTAR score was 6 (3) out of 11 for quantitative and 1 (1) for non-quantitative reviews. Among the 66 quantitative systematic reviews, there were a total of 718 pooled treatment effect estimates reported for our primary outcomes and 1012 reported pooled treatment effect estimates for secondary outcomes.
  
  
  CONCLUSIONS
  Clinicians and policy makers, when using the results of systematic reviews to inform decision-making with regard to round clinical care or healthcare policies for incretin-based medications, should consider the variability in quality of reviews.
authors.affiliation: School of Pharmacy, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
authors.forename: J-M
authors.initials: JM
authors.lastname: Gamble
authors.affiliation: School of Pharmacy, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Clarke
authors.affiliation: School of Pharmacy, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
authors.forename: K J
authors.initials: KJ
authors.lastname: Myers
authors.affiliation: School of Pharmacy, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
authors.forename: M D
authors.initials: MD
authors.lastname: Agnew
authors.affiliation: Allyn and Betty Taylor Library, Western University, London, Ontario, Canada.
authors.forename: K
authors.initials: K
authors.lastname: Hatch
authors.affiliation: School of Pharmacy, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
authors.forename: M M
authors.initials: MM
authors.lastname: Snow
authors.affiliation: School of Pharmacy, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
authors.forename: E M
authors.initials: EM
authors.lastname: Davis
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D006801:Humans; D054795:Incretins / Q000627:therapeutic use*; D064887:Observational Studies as Topic; D016032:Randomized Controlled Trials as Topic; D012196:Review Literature as Topic; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D054795:Incretins; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
keywords: incretin therapy; systematic review