The effect and safety of diacerein in patients with type 2 diabetes mellitus : a systematic review and meta-analysis.

IF 1.4 Q4 IMMUNOLOGY American journal of clinical and experimental immunology Pub Date : 2017-12-20 eCollection Date: 2017-01-01
Qi Zhang, Junteng Zhou, Yushu Wang, Decai Chen
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Abstract

The Background: Diacerein has been proposed as a treatment option for management of type 2 diabetes due to its anti-inflammatory properties.

Purpose: The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) is to examine the effect and safety of diacerein in patients with type 2 diabetes.

Data sources and study selection: We searched Pubmed, Embase, and Cochrane Library for RCTs published from database inception to September 2017.

Data extraction and data synthesis: Among 44 studies that were initially identified, four were eligible and were included in the following analysis. Diacerein significantly reduced fasting glycemia [weighted mean differences (WMD) -0.66, 95% confidence interval (95% CI) -1.16 to -0.16] and glycated hemoglobin A1c (HbA1c ) (WMD -0.85, 95% CI -1.44 to -0.26). And the patients with a diacerein supplementation duration of ≤12 weeks had a greater decrease of fasting glycemia and HbA1c than the supplementation duration of >12 weeks. Furthermore, compared with placebo, diacerein revealed a significant increase in the relative risk (RR) of gastrointestinal symptoms (RR=2.50, 95% CI: 1.10 to 5.65), especially in the study subgroup with supplementation duration of >12 weeks (RR=4.01, 95% CI: 2.32 to 6.95).

Limitations: The sample size was relatively small and the duration of included studies was short so that the treatment efficacy and safety for longer duration was unknown.

Conclusions: Although further studies are needed, our findings clearly provide support to the use of diacerein in the clinical management of subjects with type 2 diabetes.

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迪卡瑞林对 2 型糖尿病患者的疗效和安全性:系统综述和荟萃分析。
背景:目的:本系统综述和随机对照试验(RCTs)荟萃分析旨在研究2型糖尿病患者使用迪卡瑞林的效果和安全性:我们在Pubmed、Embase和Cochrane图书馆检索了从数据库建立到2017年9月发表的RCT.数据提取和数据综合:在初步确定的44项研究中,有4项符合条件并纳入了以下分析。地屈孕酮能明显降低空腹血糖[加权平均差(WMD)-0.66,95% 置信区间(95% CI)-1.16 至-0.16]和糖化血红蛋白 A1c(HbA1c )(WMD -0.85,95% CI -1.44 至-0.26)。与补充时间大于 12 周的患者相比,补充时间小于 12 周的患者的空腹血糖和 HbA1c 下降幅度更大。此外,与安慰剂相比,迪卡瑞林显著增加了胃肠道症状的相对风险(RR)(RR=2.50,95% CI:1.10 至 5.65),尤其是在补充时间超过 12 周的研究亚组中(RR=4.01,95% CI:2.32 至 6.95):局限性:样本量相对较小,纳入的研究持续时间较短,因此较长时间的疗效和安全性尚不清楚:尽管还需要进一步研究,但我们的研究结果明确支持在 2 型糖尿病患者的临床治疗中使用迪卡瑞林。
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