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Meta-Analysis
. 2014 Nov 11:8:2283-94.
doi: 10.2147/DDDT.S70945. eCollection 2014.

Risk of diarrhea in patients with type 2 diabetes mellitus treated with sitagliptin: a meta-analysis of 30 randomized clinical trials

Qingwei Zhao  1 , Dongsheng Hong  1 , Dongsheng Zheng  1 , Yao Xiao  2 , Baohua Wu  1
Affiliations
Meta-Analysis

Risk of diarrhea in patients with type 2 diabetes mellitus treated with sitagliptin: a meta-analysis of 30 randomized clinical trials

Qingwei Zhao et al. Drug Des Devel Ther. .

Abstract

Background: Sitagliptin is an important drug used for diabetes treatment and is used as a monotherapy in diabetic patients. However, there are also reported cases of diarrhea with sitagliptin use. Unfortunately, data concerning the relationship of diarrhea with sitagliptin use in various conditions have yet to be identified. Therefore, the overall incidence and risk of diarrhea with sitagliptin use have not been well defined.

Methods: We conducted searches on Embase, PubMed, and the Cochrane Library databases for relevant randomized controlled trials. Registered relevant trials at the clinical trials registration website were also searched. Statistical analyses were conducted to calculate the overall incidence, odds ratios, and 95% confidence intervals (CI) by using either random-effects or fixed-effect models according to the heterogeneity of the included studies.

Results: A total of 8,891 subjects with diabetes from 30 randomized clinical trials were included in the meta-analysis. The overall incidence of sitagliptin-associated diarrhea was 4.48% (95% CI: 3.59%-5.58%). Compared with the controls, the use of sitagliptin was not associated with a significantly increased risk of diarrhea with an odds ratio of 1.10 (95% CI: 0.78%-1.55%; P=0.58). No evidence of publication bias was observed.

Conclusion: Our study has shown that there is no difference in diarrhea risk between sitagliptin and controlled therapies. Moreover, sitagliptin is not a medicine that potentially increases the risk of diabetic diarrhea. More studies are recommended to further investigate this association.

Keywords: adverse reaction; data analysis; dipeptidyl peptidase-4 inhibitors; incidence; odds ratio; subgroup analysis.

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Figures

Figure 1
Figure 1
Flow chart demonstrating the process of study selection. Abbreviation: OHA, oral hypoglycemic agent.
Figure 2
Figure 2
Incidence of diarrhea associated with sitagliptin. Note: aProportion represents diarrhea as a proportion of the different types of reactions to sitagliptin. Abbreviations: CI, confidence interval; W, weight.
Figure 3
Figure 3
Incidence and risk of diarrhea with sitagliptin use based on subgroups. Note: aProportion represents diarrhea as a proportion of the different types of reactions to sitagliptin. Abbreviations: CI, confidence interval; W, weight.
Figure 4
Figure 4
Odds ratios of diarrhea associated with sitagliptin versus controls. Abbreviations: OR, odds ratio; CI, confidence interval; W, weight.
Figure 5
Figure 5
Funnel plot of standard error by odds ratio for diarrhea.
See this image and copyright information in PMC

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