Pharmacological research | 2021
A systematic review and dose-response meta-analysis on the efficacy of dapagliflozin in patients with type 1 diabetes mellitus.
Abstract
Formulation of insulin analogs and its delivery are developed in over recent years but glycemic control in most patients with type-1 diabetes mellitus (DM) is not adequate yet. The aim of this meta-analysis is to evaluate the efficacy of dapagliflozin in patients with type-1 DM. The MEDLINE/PubMed, Scopus, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science databases were searched up to Aug 2020 to identify the potential literature. Random-effects model (DerSimonian and Laird method) was used to estimate the pooled effect size as weighted mean difference (WMD) with 95% confidence interval (CI). Five randomized placebo-controlled trials with 11 arms were included in the quantitative analysis. The pooled results suggested a significant reduction in glycated hemoglobin A1C (HbA1C; WMD: -0.36%, 95% CI: -0.55, -0.18), body weight (WMD: -4.02\u2009kg, 95% CI: -4.78, -3.25), and total daily insulin dose (TDID; WMD: -10.36%, 95% CI: -13.42, -7.29), as well as an increase in 24\u2009-h urinary glucose excretion (24\u2009-h UGE; WMD: 90.02\u2009g/24\u2009-h, 95% CI: 72.96, 107.09) in dapagliflozin group compared to control group. Dose of dapagliflozin had a significant effect on body weight reduction (Coef=-3.7, p\u2009=\u20090.01) and 24\u2009-h UGE (coef\u2009=\u20090.85, p\u2009=\u20090.005). Pooled results of this meta-analysis identified a significant reduction in HbA1c levels, body weight, and TDID, and a substantial increase in 24\u2009-h UGE in patients who received dapagliflozin versus placebo.