SGLT-2抑制剂引起2型糖尿病患者头痛风险的网状Meta分析

A Network Meta-Analysis of Headache Risk in Type 2 Diabetes Patients Caused by SGLT-2 Inhibitors

目的:对不同SGLT-2抑制剂治疗2型糖尿病(T2DM)患者发生头痛不良反应的风险进行分析。方法:检索中英文数据库,从建库始至2022年10月15日期间发表的关于不同SGLT-2抑制剂治疗2型糖尿病的文献,进行文献筛选及数据提取,再应用Stata15.1软件进行网状Meta分析。结果:最终共纳入20篇文献,网状Meta分析结果显示,卡格列净100 mg及卡格列净300 mg与达格列净20 mg及达格列净10 mg相比,均会增加2型糖尿病患者服药期间头痛不良反应的发生;埃格列净10 mg与卡格列净300 mg及卡格列净100 mg相比,会增加2型糖尿病患者头痛的发生风险;同时,伊格列净300 mg及伊格列净200 mg与卡格列净100 mg相比,可增加2型糖尿病患者服药期间头痛不良反应的发生。结论:应用不同剂量SGLT-2抑制剂治疗2型糖尿病时,为尽可能减少头痛不良反应的发生,应优先选用达格列净20 mg、伊格列净300 mg及伊格列净200 mg。应用卡格列净300 mg及卡格列净100 mg时,2型糖尿病患者更容易发生头痛的不良反应。

Objective:To evaluate the risk of headache in patients with type 2 diabetes(T2DM)treated with different SGLT-2 inhibitors.Methods:The literatures on different SGLT-2 inhibitors for the treatment of type 2 diabetes published in the databases(from the establishment to October 15,2022)was retrieved,and then the literatures screening and data extraction were performed,the network Meta analysis was performed with Stata 15.1 software.Results:A total of 20 articles were included,and the results of network meta-analysis showed that,compared with Dapagliflozin 20 mg and Dapagliflozin 10 mg,Canagliflozin 100 mg and Canagliflozin 300 mg increased the incidence of headache adverse reactions in patients with type 2 diabetes during drug administration.The risk of headache in patients with type 2 diabetes was increased by using Ertugliflozin10 mg compared withCanagliflozin 300 mg and Canagliflozin 100 mg.At the same time,compared with Ipragliflozi 200 mg and Ipragliflozi 300 mg,Canagliflozin 100 mg,can increase the occurrence of headache adverse reactions in patients with type 2 diabetes.Conclusion:In order to reduce the occurrence of headache adverse reactions as much as possible when using different doses of SGLT-2 inhibitors in the treatment of type 2 diabetes,Dapagliflozin20 mg,Ipragliflozi 300 mg and Ipragliflozi 200 mg should be given priority.Type 2 diabetes patients are more prone to headache adverse reactions when using Canagliflozin 300 mg and Canagliflozin 100 mg.