[Impact of glucagon-like peptide-1 receptor agonists on nasopharyngitis and upper respiratory tract infection among patients with type 2 diabetes: a network meta-analysis].
OBJECTIVE
To systematically review the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on two common respiratory system adverse events (RSAE: nasopharyngitis and upper respiratory tract infection) among type 2 diabetes (T2DM).


METHODS
Medline, Embase, Clinical trials and Cochrane library were searched from inception through May 2015 to identify randomized clinical trials(RCTs) assessed safety of GLP-1RAs versus placebo or other anti-diabetic drugs in T2DM. Network meta-analysis within a Bayesian framework was performed to calculate odds ratios for the incidence of RSAE.


RESULTS
In the study, 50 RCTs were included, including 13 treatments: 7 GLP-1RAs (exenatide, exenatide-long-release-agent, liraglutide, lixisenatide, taspoglutide, albiglutide and dulaglutide), placebo and 5 traditional anti-diabetic drugs(insulin, metformin, sulfonylureas, sitagliptin and thiazolidinediones ketones). Compared with insulin, taspoglutide significantly decreased the incidence of nasopharyngitis (OR=0.67, 95%CI: 0.46-0.96). Significant lowering effects on upper respiratory tract infection were found when taspoglutide versus placebo (OR=0.57, 95%CI: 0.34-0.99) and insulin (OR=0.39, 95%CI: 0.23-0.73). The result from the network meta-analysis based on Bayesian theory could be used to rank all the treatments included, which showed that taspoglutide ranked last with minimum risk on nasopharyngitis and upper respiratory tract infection.


CONCLUSIONS
Taspoglutide was associated with significantly lowering effect on RSAE.
Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China.
Z X
ZX
Li
National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
S S
SS
Wu
Primary Care Unit, University of Cambridge, Cambridge CB21TN, UK.
Z R
ZR
Yang
Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China.
S Y
SY
Zhan
Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China.
F
F
Sun
D001499:Bayes Theorem; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000453:epidemiology*; D000077270:Exenatide; D052216:Glucagon-Like Peptide 1; D004763:Glucagon-Like Peptides / Q000031:analogs & derivatives; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D007141:Immunoglobulin Fc Fragments; D007328:Insulin; D000069450:Liraglutide; D008687:Metformin; D009304:Nasopharyngitis / Q000453:epidemiology*; D010455:Peptides / Q000009:adverse effects / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D011993:Recombinant Fusion Proteins; D012141:Respiratory Tract Infections / Q000453:epidemiology*; D045162:Thiazolidinediones; D014688:Venoms; D000097789:Glucagon-Like Peptide-1 Receptor Agonists; D000067758:Glucagon-Like Peptide-2 Receptor
D000077270:Exenatide; D052216:Glucagon-Like Peptide 1; D004763:Glucagon-Like Peptides; D007004:Hypoglycemic Agents; D007141:Immunoglobulin Fc Fragments; D007328:Insulin; D000069450:Liraglutide; D008687:Metformin; D010455:Peptides; D011993:Recombinant Fusion Proteins; D045162:Thiazolidinediones; D014688:Venoms; D000097789:Glucagon-Like Peptide-1 Receptor Agonists; C541736:taspoglutide; C479460:lixisenatide; D000067758:Glucagon-Like Peptide-2 Receptor; C555680:dulaglutide