Efficacy And Safety Of The Novel Dipeptidyl Peptidase-4 Inhibitor Gemigliptin In The Management Of Type 2 Diabetes: A Meta-Analysis

Background: No meta-analysis has holistically analysed and summarised the efficacy and safety of gemigliptin in type 2 diabetes. The meta-analysis addresses this knowledge gap.Methods: Electronic databases were searched for randomised controlled trials (RCTs) involving diabetes patients receiving gemi-gliptin in the intervention arm and placebo/active comparator in the control arm. The primary outcome was change in haemoglobin A1c (HbA1c). The secondary outcomes were alterations in glucose, glycaemic targets, lipids, insulin resistance, and adverse events.Results: Data from 10 RCTs involving 1,792 patients were analysed. Four had an active control group (ACG), with metformin/ dapagliflozin/sitagliptin/glimepiride as the active comparator; six had a passive control group (PCG), with placebo/rosuvastatin as controls. HbA1c reduction by gemigliptin at 24 weeks was comparable to ACG (mean difference [MD], 0.09%; 95% confidence interval [CI], -0.06 to 0.23; P=0.24; I-2=0%; moderate certainty of evidence [MCE]), but superior to PCG (MD, -0.91%; 95% CI, -1.18 to -0.63); P< 0.01; I-2= 89%; high certainty of evidence [HCE]). Gemigliptin was superior to PCG regarding achieving HbA1c < 7% (12 weeks: odds ratio [OR], 5.91; 95% CI, 1.34 to 26.08; P= 0.02; I-2= 74%; 24 weeks: OR, 4.48; 95% CI, 2.09 to 9.60; P< 0.01; I-2= 69%; HCE). Gemigliptin was comparable to ACG regarding achieving HbA1c < 7% after 24 weeks (OR, 0.92; 95% CI, 0.52 to 1.63; P=0.77; I-2= 66%; MCE). Adverse events were similar between the gemigliptin and control groups (risk ratio [RR], 1.06; 95% CI, 0.82 to 1.36; P=0.66; I2= 35%; HCE). The gemigliptin group did not have increased hypoglycaemia (RR, 1.19; 95% CI, 0.62 to 2.28; P= 0.61; I-2= 19%; HCE).Conclusion: Gemigliptin has good glycaemic efficacy and is well-tolerated over 6 months of use.