Meta-Analysis
Copyright ©The Author(s) 2015.
World J Meta-Anal. Dec 26, 2015; 3(6): 254-283
Published online Dec 26, 2015. doi: 10.13105/wjma.v3.i6.254
Table 1 Characteristics of glucagon-like peptide-1 based agents in randomized controlled trials included in analysis of pancreatic events
Ref.Location (No. of centers)Year of study completionTotal duration (wk)Duration of GLP-1 exposure (wk)Participant diseaseArmsNo. of participantsMean age, yr (SD)Female, n (%)
Ross et al[21]Multi-national (84 centers in 9 countries)20104312Type 2 diabetesLinagliptin 2.5 mg bid22358.7 (9.9)85 (38.1)
Linagliptin 5 mg qd22458.4 (10.6)103 (46.0)
Placebo4459.9 (10.7)23 (52.3)
Haak et al[22]Multi-national (133 clinics in 14 countries)20107324Type 2 diabetesLinagliptin 5 mg qd14256.2 (10.8)62 (43.7)
Metformin 500 mg bid14452.9 (10.4)62 (43.1)
Metformin 1000 mg bid14755.2 (10.6)69 (46.9)
Linagliptin 2.5 mg qd + Metformin 500 mg bid14355.6 (11.2)73 (49.0)
Linagliptin 2.5 mg qd + Metformin 1000 mg bid14356.4 (10.7)66 (46.2)
Placebo7255.7 (11.0)36 (50)
NCT00328172[23]Multi-national (71 sites in 6 countries)20076512Type 2 diabetesLinagliptin 0.5 mg5858.0 (9.4)13 (22.4)
Linagliptin 2.5 mg5759.8 (10.3)30 (52.6)
Linagliptin 5.0 mg5556.6 (9.6)24 (43.6)
Metformin6553.7 (10.7)26 (40.0)
Placebo6758.6 (8.9)34 (50.7)
Yki-Jarvinen et al[24,25]Multi-national (169 sites in 19 countries)201110852Type 2 diabetesLinagliptin 5.0 mg63159.7 (9.9)302 (47.9)
Placebo63060.4 (10.0)301 (47.8)
NCT00654381[26]Japan20109112Type 2 diabetesLinagliptin 5.0 mg15960.3 (9.4)48 (30.2)
Linagliptin 10.0 mg16061.3 (10.0)48 (30.0)
Voglibose16258.5 (9.9)47 (29.0)
Placebo8059.7 (8.9)23 (28.7)
NCT00622284[27]Multi-national (221 sites in 16 countries)2010146104Type 2 diabetesLinagliptin77659.8 (9.4)314 (40.5)
Glimepiride77559.8 (9.4)304 (39.2)
BI Trial No: 1218.15/ U09-2519-01[28]Multi-national (43 sites in 7 countries)20096124Type 2 diabetesLinagliptin 5 mg + Pioglitazone 30 mg259NRNR
Pioglitazone 30 mg + Placebo130NRNR
BI Trial No: 1218.52/U11-1782-01[29]Multi-national (101 sites in 14 countries)201110254Type 2 diabetesLinagliptin 2.5 mg + Metformin (500 mg and 1000 mg bid)396NRNR
Metformin 1000 mg bid170NRNR
BI Trial No: 1218.63/U11-1781-02[30]Multi-national (33 sites in 5 countries)20116724Type 2 diabetesLinagliptin 5 mg162NR46 (28.4)
Placebo79NR30 (38.0)
BI Trial No: 1218.75/U12-3204-01[31]Multi-center study (Black/African American patients only)20115524Type 2 diabetesLinagliptin 5 mg106NRNR
Placebo120NRNR
BI Trial No: 1218.61/U13-3124-01[32]Multi-national study (4 countries)201212324Type 2 diabetesLinagliptin 5 mg183NRNR
Placebo89NRNR
BI Trial No: 1218.65/U12-2143-01[33]Multi-national study (19 sites in 3 countries)20127424Type 2 diabetesLinagliptin 5 mg20582%(< 65 yr)NR
Placebo10083% (< 65 yr)NR
BI Trial No: 1218.64/U13-1283-01[34]Multi-national study (52 sites in 9 countries)201211752Type 2 diabetesLinagliptin 5 mg113NR43 (38.1)
Placebo (first 12 wk)/ Glimepiride (next 40 wk)122NR43 (35.2)
BI Trial No: 1218.66/U12-2076-01[35]Multi-national study (19 sites in 3 countries20128024Type 2 diabetesLinagliptin 5 mg20084.0% (< 65 yr)NR
Placebo9989.9% (< 65 yr)NR
Rosenstock et al[36]Multi-national study (110 sites in 13 countries)20076526Type 2 diabetesAlogliptin 12.5 mg13155.4 (9.8)76 (58)
Alogliptin 25 mg12955.9 (10.2)85 (66)
Placebo13055.0 (10.6)68 (52)
White et al[37]Multi-national study (898 centers in 49 countries)201319376 (median)Type 2 diabetesAlogliptin270136.0% (≥ 65 yr)873 (32.3)
Placebo267934.9% (≥ 65 yr)856 (32.0)
NCT01318135[38]Japan (58 sites)20105252Type 2 diabetesAlogliptin 12.5 mg qd + Glimepiride 1-6 mg qd or bid15038.0% (≥ 65 yr)53 (35.3)
Alogliptin 25 mg qd + Glimepiride 1-6 mg qd or bid15230.9% (≥ 65 yr)52 (34.2)
NCT01289119[39]Multi-national study (21 sites in 3 countries)20115216Type 2 diabetesAlogliptin monotherapy9251.6 (10.41)37 (40.2)
Metformin9853.2 (9.46)50 (51.0)
Metformin + Alogliptin Add-on Therapy9953.0 (9.88)48 (48.5)
Pioglitazone6351.8 (10.37)24 (38.1)
Pioglitazone + Alogliptin Add-on Therapy6152.6 (9.44)33 (54.1)
Placebo9353.1 (8.88)39 (41.9)
NCT01263496[40]Japan (58 sites)20087252Type 2 diabetesAlogliptin 6.25 mg qd9628.1 (≥ 65 yr)26 (27.1)
Alogliptin 12.5 mg qd10133.7 (≥ 6 5 yr)29 (28.7)
Alogliptin 25 mg qd9734.0 (≥ 65 yr)22 (22.7)
Alogliptin 50 mg qd9732.9 (≥ 65 yr)29 (29.9)
Voglibose 0.2 mg tid8338.6 (≥ 65 yr)27 (32.5)
NCT00328627[41]Multi-national study (90 sites in 19 countries)20089326Type 2 diabetesAlogliptin 12.5 mg + Placebo12853.1 (9.59)61 (47.6)
Alogliptin 25 mg + Placebo12953.7 (9.31)79 (61.2)
Placebo12955.2 (9.89)68 (52.7)
NCT00395512[42]Multi-national study (268 sites in 23 countries)20086726Type 2 diabetesAlogliptin 25 mg + Pioglitazone 30 mg16452.8 (11.01)91 (55.5)
Alogliptin 12.5 mg + Pioglitazone 30 mg16453.5 (11.37)83 (50.6)
Pioglitazone 30 mg16351.5 (10.72)73 (44.8)
Kikuchi et al[43]Japan (26 sites)20075212Type 2 diabetesVildagliptin 50 mg bid + glimepiride10259.2 (9.8)27 (26.5)
Placebo + glimepiride10060.3 (10.1)31 (31.0)
Lukashevich et al[44]Multi-national study (12 countries)201029124Type 2 diabetesVildagliptin 50 mg qd (moderate RI)16567.7 (8.8)69 (41.8)
Placebo (moderate RI)12969.7 (7.3)49 (38.0)
Vildagliptin 50 mg qd (severe RI)12464.1 (9.2)59 (47.6)
Placebo (severe RI)9764.5 (10.8)44 (45.4)
Strain et al[45]Multi-national study (45 centers in 7 countries)20126424Type 2 diabetesVildagliptin13975.1 (4.3)66 (47.5)
Placebo13974.4 (4.0)86 (61.9)
NCT00106340[46] (CLAF237A2308)Multi-national study (402 centers in 25 countries)2008166104Type 2 diabetesVildagliptin 50 mg bid + Metformin156257.5 (9.07)733 (46.9)
Glimepiride up to 6 mg qd + Metformin155657.5 (9.19)718 (46.1)
NCT00300287[47] (CLAF237A2307)Multi-national study (69 centers in 6 countries)20068552Type 2 diabetesVildagliptin 50 mg qd15663.27 (10.18)63 (40.4)
Placebo15062.84 (11.03)61 (40.7)
CLAF237A1301[48]Japan (51 centers)20074412Type 2 diabetesVildagliptin 50 mg bid18860.3 (10.48)67 (35.6)
Voglibose 0.2 mg tid19258.0 (9.32)62 (32.3)
CLAF237A23119[49]United States (796 centers)20075312Type 2 diabetesVildagliptin 100 mg + Metformin177655.3864 (48.6)
Thiazolinedione + Metformin88856.2467 (52.6)
NCT00110240[50] (CLAF237A2323)Multi-national study (31 centers in 3 countries)20068724Type 2 diabetesVildagliptin 50 mg bid44151.79 (10.13)176 (40.0)
Acarbose up to 100 mg tid22051.93 (10.34)81 (37.0)
NCT00327015[51]Multi-national study (211 sites in 13 countries)20077824Type 2 diabetesSaxagliptin 5 mg + Metformin 500 mg32051.95 (10.43)155 (48.4)
Saxagliptin 10 mg + Metformin 500 mg32352.08 (11.59)177 (54.8)
Metformin 500 mg + Placebo32851.83 (10.74)165 (50.3)
Hollander et al[52]Multi-national study (133 sites in 7 countries)20078224Type 2 diabetesSaxagliptin 2.5 mg + TZD19554.9 (9.7)89 (45.6)
(NCT00295633)Saxagliptin 5 mg + TZD18653.2 (10.6)97 (52.2)
Placebo + TZD18454.0 (10.1)99 (53.8)
NCT00757588[53]Multi-national study (80 sites in 10 countries)20107324Type 2 diabetesSaxagliptin 5 mg + Insulin30457.2 (9.4)184 (60.5)
Placebo + Insulin15157.3 (9.3)83 (54.9)
Scirica et al[54]Multi-national study (788 sites in 26 countries)2013156109Type 2 diabetesSaxagliptin828065.1 (8.5)2768 (33.4)
Placebo821265 (8.6)2687 (32.7)
Göke et al[55]Multi-national study (130 sites in 11 countries)2010139104Type 2 diabetesSaxagliptin + Metformin42857.5 (10.26)216 (50.5)
Glipizide + Metformin43057.59 (10.37)198 (46.1)
NCT00316082[56]Multi-national study (74 sites in 4 countries)20077424Type 2 diabetesSaxagliptin 2.5/5 mg QAM7154.28 (10.93)34 (47.9)
Saxagliptin 2.5 mg QAM7455.24 (10.44)49 (66.2)
Saxagliptin 5 mg QAM7454.66 (9.71)36 (48.6)
Saxagliptin 5 mg QPM7255.11 (10.35)39 (54.2)
Placebo7455.57 (10.32)39 (52.7)
NCT00614939[57]Multi-national study (74 sites in 14 countries)20097412Type 2 diabetesSaxagliptin8566.8 (8.3)53 (62.4)
Placebo8566.2 (9.1)44 (51.8)
Chan et al[58,59]Multi-national study (30 sites in 13 countries)2006NR54Type 2 diabetesSitagliptin 50 mg or 25 mg once daily6568.9 (9.8)34 (52.3)
Glipizide2665.3 (9.7)10 (38.5)
Kojima et al[60]Japan (Japanese Red Cross Medical Center)20116512Type 2 diabetesSitagliptin2063.85 (12.92)5 (0.25)
Nateglinide1666.44 (9.02)4 (0.25)
NCT00509262Multi-national study201117854Type 2 diabetesSitagliptin21164.2 (10.7)80 (37.9)
(Arjona Ferreira et al[61,62])
Glipizide21264.2 (9.4)90 (42.5)
Henry et al[63,64]Multi-national study201010854Type 2 diabetesSitagliptin 100 mg/Pioglitazone 15 mg230NR112 (48.7)
Sitagliptin 100 mg/Pioglitazone 30 mg231NR96 (41.6)
Sitagliptin 100 mg/Pioglitazone 45 mg230NR
95 (41.3)
Pioglitazone 15 mg230NR82 (35.7)
Pioglitazone 30 mg233NR106 (45.5)
Pioglitazone 45 mg230NR117 (50.9)
Raz et al[65,66]Multi-national study (30 sites in 13 countries)20074730Type 2 diabetesSitagliptin 100 mg9653.6 (9.5)47 (48.9)
Placebo9456.1 (9.5)55 (58.5)
NCT01131182[67]NR2010224Type 2 diabetesSitagliptin50755.0 (11.0)238 (46.9)
Sulfonylurea51455.0 (11.0)259 (50.4)
Goldstein et al[68,69]Multi-national study20066954Type 2 diabetesSitagliptin 50 mg bid + Metformin 500 mg bid19054.1 (10.0)85 (44.7)
Sitagliptin 50 mg bid + Metformin 1000 mg bid18253.3 (9.6)105 (57.7)
Sitagliptin 50 mg bid + Metformin 1000 mg bid (Open Label Cohort)11752.6 (10.0)50 (42.7)
Metformin 500 mg bid18253.4 (10.2)93 (51.1)
Metformin 1000 mg bid18253.2 (9.6)100 (54.9)
Placebo/Metformin 1000 mg bid17653.6 (10.0)83 (47.2)
Arechavaleta et al[70,71]Multi-national study20097430Type 2 diabetesSitagliptin51656.3 (9.7)232 (44.9)
Glimepiride51956.2 (10.1)240 (46.2)
NCT00086515 et al[72,73]Multi-national study200713524Type 2 diabetesSitagliptin 100 mg46454.4 (10.4)205 (44.2)
Placebo/Glipizide 5 mg23754.7 (9.7)96 (40.5)
Bergenstal et al[74,75]Multi-national study (62 sites in 3 countries)20095626Type 2 diabetesExenatide once weekly16052.4 (10.41)71 (44.4)
Sitagliptin16652.2 (10.54)80 (48.2)
Pioglitazone16553.0 (9.92)86 (52.1)
NCT00094757[76]Multi-national study20067854Type 2 diabetesSitagliptin 100 mg20554.5 (10.0)95 (46.3)
Sitagliptin 200 mg20655.4 (9.2)102 (49.5)
Placebo/Pioglitazone11055.5 (10.1)41 (37.3)
NCT00094770[77]Multi-national study (173 sites in 27 countries)2006139104Type 2 diabetesSitagliptin 100 mg58856.8 (9.3)252 (42.8)
Glipizide58456.6 (9.8)226 (38.7)
NCT01137812[78,79]Multi-national study (182 sites in 17 countries)20128752Type 2 diabetesSitagliptin 100 mg37856.6 (9.33)163 (43.1)
Canagliflozin 300 mg37756.5 (9.62)170 (45.1)
NCT00482729[80]Multi-national study (209 sites in United States)20087444Type 2 diabetesSitagliptin/Meformin-Fixed Dose Combination62549.5 (10.5)272 (43.5)
Metformin62150.0 (10.5)266 (42.8)
Bunck et al[81]Multi-national study (3 sites in 3 countries)200715452Type 2 diabetesExenatide3658.4 (1.4)13 (36.1)
Insulin glargine3358.3 (1.3)11 (33.3)
Diamant et al[82]Multi-national study (72 sites in 7 countries)20095326Type 2 diabetesExenatide23358.0 (10.0)113 (48.0)
Insulin glargine22358 (9.0)100 (45.0)
Inagaki et al[83]Japan (22 sites)20106126Type 2 diabetesExenatide once weekly21557.07 (10.44)73 (34.0)
Insulin glargine once daily21256.44 (11.16)64 (30.2)
Russell-Jones et al[84]Multi-national study (106 sites in 22 countries)20108226Type 2 diabetesExenatide 2 mg once weekly + Oral placebo24853.7 (10.91)109 (43.9)
Sitagliptin 100 mg/d + SC placebo16352.3 (11.05)69 (42.3)
Metformin starting at 1000 mg/d + SC placebo24653.7 (11.08)92 (37.4)
Pioglitazone starting at 30 mg/d+ SC placebo16355.3 (10.96)66 (40.5)
NCT01003184[85]34 sites in Ireland and United Kingdom20119126Type 2 diabetesExenatide once weekly11159.2 (9.86)40 (36.04)
Insulin Detemir twice daily10557.8 (9.48)33 (31.4)
Astrup et al[86]Multi-national study (19 sites in 8 European countries)2009117104Type 2 diabetesLiraglutide 1.2 mg9547.18 (9.72)73 (76.8)
Liraglutide 1.8 mg9045.53 (10.9)68 (75.6)
Liraglutide 2.4 mg9345.01 (11.09)71 (76.3)
Liraglutide 3.0 mg9345.91 (10.71)70 (75.3)
Placebo9845.86 (10.28)74 (75.5)
Garber et al[87]126 sites in United States and 12 sites in Mexico20079152Type 2 diabetesLiraglutide 1.2 mg25153.7 (11.0)134 (53.4)
Liraglutide 1.8 mg24752.0 (10.8)126 (51.0)
Glimepiride 8 mg24853.4 (10.9)115 (46.4)
Nauck et al[88]Multi-national study (170 sites in 21 countries)20075226Type 2 diabetesOnce daily Liraglutide (0.6 mg)24256.0 (11.0)91 (37.6)
Once daily Liraglutide (1.2 mg)24157 (9.0)111 (46.1)
Once daily Liraglutide (1.8 mg)24257 (9.0)100 (41.3)
Once daily Glimepiride (4 mg)24457 (9.0)103 (42.2)
Placebo12256 (9.0)49 (40.2)
Marre et al[89]Multi-national study (116 sites in 21 countries)NRNR26Type 2 diabetesLiraglutide 0.6 mg23355.7 (9.9)107 (46.0)
Liraglutide 1.2 mg22857.7 (9.0)125 (55.0)
Liraglutide 1.8 mg23455.6 (10.0)110 (47.0)
Placebo11454.7 (10.0)60 (53.0)
Zinman et al[90]90 sites in United States and Canada20076526Type 2 diabetesLiraglutide 1.2 mg17855.0 (10.0)77 (43.0)
Liraglutide 1.8 mg17855.0 (11.0)87 (49.0)
Placebo17755.0 (10.0)67 (38.0)
Raz et al[91]Multi-national study (53 centers in 11 countries)201113424Type 2 diabetesTaspoglutide 10 mg116NRNR
Taspoglutide 20 mg129NRNR
Placebo123NRNR
Rosenstock et al[92]Multi-national study (118 sites in 4 countries)20085616Type 2 diabetesAlbiglutide 4 mg weekly3550.4 (10.3)20 (57.1)
Albiglutide 15 mg weekly3555.5 (10.5)17 (48.6)
Albiglutide 30 mg weekly3154.2 (9.7)23 (74.2)
Albiglutide 15 mg biweekly3352.5 (9.6)19 (57.6)
Albiglutide 30 mg biweekly3255.5 (9.9)16 (50.0)
Albiglutide 50 mg biweekly3551.1 (10.3)16 (45.7)
Albiglutide 50 mg monthly3554.1 (11.3)18 (51.4)
Albiglutide 100 mg monthly3454.4 (9.9)15 (44.1)
Placebo5154.0 (10.6)23 (45.1)
Seino et al[93]Multi-national study (57 centers in 4 Asian countries)NRNR24Type 2 diabetesLixisenatide (10 ug for 1 wk, 15 mg for 1 wk, then 20 mg-maintenance dose)15458.7 (10.2)85 (55.2)
Placebo15758.0 (10.1)77 (49.0)
Umpierrez et al[94]36 sites in United States and 3 in Puerto Rico20083916Type 2 diabetesLY2189265 (LY 0.5/1.0)6659.0 (12.0)31 (47.0)
LY2189265 (LY 1.0/1.0)6557.0 (12.0)30 (46.0)
LY2189265 (LY 1.0/2.0)6554.0 (11.0)31 (48.0)
Placebo6656.0 (12.0)37 (56.0)