Authors' recommendations: CONCLUSIONS High quality evidence shows that in patients with type 2 diabetes mellitus, first-line therapy with dipeptidyl peptidase-4 inhibitors plus metformin is associated to a slight reduction in glycosylated hemoglobin, fasting plasma glucose and weight; however, its use as monotherapy does not have any benefit. As second-line therapy, its combination with metformin is associated to weight loss and fewer hypoglycemia events; also, low quality evidence associates it with low risk of cardiovascular events when compared with metformin plus sulfonylureas. As third-line therapy, its use added to insulin was associated to a significant reduction in glycosylated hemoglobin and plasma glucose. As regards safety, the use of saxagliptin is associated to a higher risk of experiencing heart failure. The clinical practice guidelines identified suggest them as a therapeutic alternative as first-line (when there intolerance or metformin is contraindicated); they also suggest its use in combination with metformin (as well as other alternatives) as second-line therapy when the first-line clinical goal has not been achieved.

Project Status: Completed

Year Published: 2017

URL for published report: https://www.iecs.org.ar/home-ets/

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)