DPP-4 inhibitors and risk of infections: A meta-analysis of randomized controlled trials

Abstract

Background: To evaluate the risk of infections in the treatment of type 2 diabetes patients with dipeptidyl-peptidase 4 (DPP-4) inhibitors. Methods: A literature search was conducted through electronic databases. The inclusion criteria included study duration of no less than 12 weeks developed in type 2 diabetes patients, the use of a randomized control group receiving a DPP-4 inhibitor and the availability of outcome data for infections. Out of 2181 studies, 74 studies were finally included. Results: The risk of overall infection for DPP-4 inhibitors treatment was comparable to placebo (odds ratio (OR)=0.97, 95% confidence interval (CI), 0.91 to 1.04, p=0.40), metformin treatment (OR=1.22, 95% CI, 0.95 to 1.56, p=0.12), sulphonylurea treatment (OR=1.09, 0.93 to 1.29, p=0.29), thiazolidinedione treatment (OR=0.86, 95% CI, 0.65 to 1.14, p=0.29) and alpha glucosidase inhibitor treatment (OR=1.03, 95% CI, 0.33 to 3.22, p=0.96). When compared different DPP-4 inhibitors with placebo treatment, risks of infections were comparable for alogliptin, linagliptin, sitagliptin, saxagliptin and vildagliptin. Compared with placebo or active comparator treatment, risks of infection in different systems for DPP-4 inhibitors were all comparable. Conclusions: The overall risk of infections of DPP-4 inhibitor was not increased compared with control groups.