title: Systematic review and meta-analysis of vildagliptin for treatment of type 2 diabetes.
abstract: This systematic review and meta-analysis provides an update on the efficacy and safety of vildagliptin for treatment of type 2 diabetes mellitus (T2DM). We searched MEDLINE, COCHRANE, EMBASE and the drug manufacturer's website for randomised controlled trials of vildagliptin in patients with T2DM. Sixty-nine studies (28,006 patients) were included in the meta-analysis. Compared with placebo vildagliptin reduced HbA1c (weighted mean difference WMD -0.69 %; 95 % CI -0.83 to -0.56 %; I (2) = 82 %), and it was as effective as other antidiabetic agents (WMD -0.01 %; 95 % CI -0.16 to 0.14 %; I (2) = 93 %), without increasing the risk for hypoglycemia (OR 0.83; 95 % CI 0.59 to 1.16; I (2) = 0 % vs. placebo, and OR 0.19; 95 % CI 0.15 to 0.24; I (2) = 78 % versus active comparators). However, it was associated with an increase in the incidence of arthralgia compared with other comparators (OR 1.23; 95 % CI 1.02 to 1.48; I (2) = 0 %). On the contrary, vildagliptin did not increase the incidence of pancreatitis (OR 0.97; 95 % CI 0.37 to 2.53; I (2) = 0 %), serious adverse events (OR 0.98; 95 % CI 0.88 to 1.09; I (2) = 0 %) or death (OR 1.10, 95 % CI 0.75 to 1.61; I (2) = 0 %). Finally, odds ratio (OR) for heart failure, and overall cardiovascular and cerebrovascular events was 0.77 (95 % CI 0.46 to 1.30; I (2) = 0 %) and 0.91 (95 % CI 0.73 to 1.14; I (2) = 0 %), respectively. Vildagliptin is an effective and safe therapeutic option for patients with T2DM, both as monotherapy and as add-on treatment.
authors.affiliation: Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University Thessaloniki, Hippokratio General Hospital, 49 Konstantinoupoleos Street, 54642, Thessaloníki, Greece.|Diabetes Centre, Second Medical Department, Aristotle University Thessaloniki, Thessaloníki, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Bekiari
authors.affiliation: Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University Thessaloniki, Hippokratio General Hospital, 49 Konstantinoupoleos Street, 54642, Thessaloníki, Greece.
authors.forename: Chrysoula
authors.initials: C
authors.lastname: Rizava
authors.affiliation: Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University Thessaloniki, Hippokratio General Hospital, 49 Konstantinoupoleos Street, 54642, Thessaloníki, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Athanasiadou
authors.affiliation: Diabetes Centre, Second Medical Department, Aristotle University Thessaloniki, Thessaloníki, Greece.|Second Medical Department, Democritus University Thrace, Alexandroupoli, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Papatheodorou
authors.affiliation: Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University Thessaloniki, Hippokratio General Hospital, 49 Konstantinoupoleos Street, 54642, Thessaloníki, Greece.
authors.forename: Aris
authors.initials: A
authors.lastname: Liakos
authors.affiliation: Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University Thessaloniki, Hippokratio General Hospital, 49 Konstantinoupoleos Street, 54642, Thessaloníki, Greece.
authors.forename: Thomas
authors.initials: T
authors.lastname: Karagiannis
authors.affiliation: Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University Thessaloniki, Hippokratio General Hospital, 49 Konstantinoupoleos Street, 54642, Thessaloníki, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Mainou
authors.affiliation: Diabetes Centre, Second Medical Department, Aristotle University Thessaloniki, Thessaloníki, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Rika
authors.affiliation: Second Medical Department, Aristotle University Thessaloniki, Thessaloníki, Greece.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Boura
authors.affiliation: Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University Thessaloniki, Hippokratio General Hospital, 49 Konstantinoupoleos Street, 54642, Thessaloníki, Greece. atsapas@auth.gr.|Diabetes Centre, Second Medical Department, Aristotle University Thessaloniki, Thessaloníki, Greece. atsapas@auth.gr.|Harris Manchester College, University of Oxford, Oxford, UK. atsapas@auth.gr.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Tsapas
mesh_terms: D000218:Adamantane / Q000031:analogs & derivatives* / Q000627:therapeutic use; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008687:Metformin / Q000627:therapeutic use; D009570:Nitriles / Q000627:therapeutic use*; D010195:Pancreatitis / Q000139:chemically induced / Q000453:epidemiology; D011759:Pyrrolidines / Q000627:therapeutic use*; D016896:Treatment Outcome; D000077597:Vildagliptin
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D009570:Nitriles; D011759:Pyrrolidines; D008687:Metformin; D000077597:Vildagliptin; D000218:Adamantane
keywords: DPP-4 inhibitors; Meta-analysis; Systematic review; Vildagliptin