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德谷胰岛素利拉鲁肽注射液与甘精胰岛素利司那肽注射液治疗

          2型糖尿病的网状Meta分析
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          王笑梅    1, 2* ,游晓炎 ,秦佳丽 ,刘 洋 ,王宪英 (1.河北医科大学第三医院药剂科,石家庄 050051;2.河北
                            1, 2
                                     1, 2
                                               1
          医科大学研究生院,石家庄 050017)
          中图分类号  R587.1;R977.1+5      文献标志码  A      文章编号  1001-0408(2025)07-0874-07
          DOI  10.6039/j.issn.1001-0408.2025.07.19

          摘   要  目的  系统评价德谷胰岛素利拉鲁肽注射液(IDegLira)和甘精胰岛素利司那肽注射液(iGlarLixi)治疗 2 型糖尿病
         (T2DM)的有效性和安全性,为临床治疗T2DM提供循证依据。方法  计算机检索 PubMed、Embase、the Cochrane Library、中国知
          网、万方数据、维普网,检索时限从建库起至2024年8月。根据纳入排除标准,严格筛选随机对照试验(RCT),从中提取资料并对
          纳入研究进行偏倚风险评价,采用Stata 14.0软件进行网状Meta分析。结果  共纳入15项RCT,包括9 513例患者,涉及4种治疗
          方案:IDegLira、iGlarLixi、德谷胰岛素(IDeg)、甘精胰岛素(iGlar)。在糖化血红蛋白(HbA1c)、空腹血糖、体重和不良事件发生率结
          局指标方面,IDegLira与iGlarLixi差异均无统计学意义(P>0.05);在低血糖事件发生率结局指标方面,IDegLira显著优于iGlarLixi
          [OR=0.41,95%CI(0.18,0.91),P<0.05]。累积排序概率曲线下面积(SUCRA)排序结果显示,在降低 HbA1c 方面,iGlarLixi
         (84.5%)>IDegLira(81.7%);在降低空腹血糖方面,IDegLira(71.3%)>iGlarLixi(20.0%);在降低体重方面,IDegLira(90.7%)>
          iGlarLixi(61.8%);在降低低血糖事件发生率方面,IDegLira(95.5%)>iGlarLixi(9.7%);在降低不良事件发生率方面,IDegLira
         (27.1%)>iGlarLixi(14.5%)。结论  iGlarLixi 在降低 HbA1c 方面效果更好,IDegLira 在降低空腹血糖、体重方面治疗效果更好;
          IDegLira低血糖风险最低。
          关键词  德谷胰岛素利拉鲁肽注射液;甘精胰岛素利司那肽注射液;德谷胰岛素;甘精胰岛素;2型糖尿病;体重增加;低血糖

          Network meta-analysis of Insulin degludec and liraglutide injection versus Insulin glargine and lixisenatide
          injection in the treatment of type 2 diabetes mellitus
                                                    1, 2
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                                                                                 1
          WANG Xiaomei ,YOU Xiaoyan ,QIN Jiali ,LIU Yang ,WANG Xianying(1.  Dept.  of  Pharmacy,  Hebei
                                                                1
          Medical University Third Hospital, Shijiazhuang 050051, China;2. Graduate School, Hebei Medical University,
          Shijiazhuang 050017, China)
          ABSTRACT    OBJECTIVE  To  systematically  evaluate  the  efficacy  and  safety  of  Insulin  degludec  and  liraglutide  injection
         (IDegLira)  and  Insulin  glargine  and  lixisenatide  injection(iGlarLixi)  in  the  treatment  of  type  2  diabetes  mellitus(T2DM),  and
          provide an evidence-based basis for the clinical treatment of T2DM. METHODS Computerized searches of PubMed, Embase, the
          Cochrane  Library,  CNKI,  Wanfang  data  and  VIP  were  conducted  with  a  time  frame  from  the  inception  to  August  2024.
          Randomized controlled trials(RCTs) were rigorously screened according to inclusion and exclusion criteria, from which information
          was extracted and included studies were evaluated for risk of bias. Network meta-analysis was performed using Stata 14.0 software.
          RESULTS A total of 15 RCTs, including 9 513 patients, were included, involving four treatment regimens: IDegLira, iGlarLixi,
          insulin  degludec(IDeg),  and  insulin  glargine(iGlar).  The  differences  between  IDegLira  and  iGlarLixi  were  not  statistically
          significant(P>0.05)  for  the  outcome  indexes  of  glycosylated  hemoglobin(HbA1c),  fasting  blood  glucose,  body  weight,  and  the
          incidence of adverse events(P>0.05); for the outcome index of the incidence of hypoglycemic events, IDegLira was significantly
          superior  to  iGlarLixi  [OR=0.41,95%CI(0.18,0.91),P<0.05].  Surface  under  the  cumulative  ranking  curve(SUCRA)  results
          showed  that  iGlarLixi(84.5%)>IDegLira(81.7%)  in  lowering  HbA1c;  IDegLira(71.3%)>iGlarLixi(20.0%)  in  lowering  fasting
          blood glucose; IDegLira(90.7%)>iGlarLixi(61.8%) in lowering body weight; IDegLira(95.5%)>iGlarLixi(9.7%) in reducing the
          incidence  of  hypoglycemic  events;  and  IDegLira(27.1%)>iGlarLixi(14.5%)  in  reducing  the  incidence  of  adverse  events.
          CONCLUSIONS  iGlarLixi  has  better  therapeutic  efficacy  in  reducing  HbA1c;  IDegLira  has  better  therapeutic  efficacy  in  reducing
          fasting blood glucose and body weight. IDegLira has the lowest risk of hypoglycemia.
                                                              KEYWORDS    Insulin  degludec  and  liraglutide  injection;
              Δ 基金项目 河北省医学科学研究课题(No.20240829)
             *第一作者 硕士研究生。研究方向:临床药学。E-mail:wxm_                Insulin  glargine  and  lixisenatide  injection;  insulin  degludec;
          1234560@163.com                                     insulin  glargine;  type  2  diabetes  mellitus;  gain  weight;
              # 通信作者 主任药师,硕士生导师,博士。研究方向:医院药学、                 hypoglycemia
          药物经济学。E-mail:37300643@hebmu.edu.cn


          · 874 ·    China Pharmacy  2025 Vol. 36  No. 7                               中国药房  2025年第36卷第7期
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