Most add-on therapies to metformin have similar effects on HbA1c
Systematic review with meta-analysis
Thomas Karagiannis1,
Eleni Bekiari1,2
1Clinical Research and Evidence-Based Medicine Unit, Aristotle University Thessaloniki, Thessaloniki, Greece
2Second Medical Department, Diabetes Centre, Aristotle University Thessaloniki, Thessaloniki, Greece
Correspondence to: Dr Thomas Karagiannis, Clinical Research and Evidence-Based Medicine Unit, Aristotle University Thessaloniki, 49 Konstantinoupoleos Street, Thessaloniki 54642, Greece; tkaragian{at}auth.gr
Commentary on: Maruthur NM, Tseng E, Hutfless S, et al. Diabetes medications as monotherapy or metformin-based combination therapy for type 2 diabetes: a systematic review and meta-analysis. Ann Intern Med 2016;164(11):740–51 OpenUrlCrossRefPubMed.
Current guidelines for type 2 diabetes recommend metformin as first-line therapy, but offer no conclusive guidance for choosing among at least six drug classes as add-on to metformin in patients in whom glycaemic targets are not met.1 In light of accumulating evidence for novel agents, it is imperative to update the comparative effectiveness and safety of available antidiabetic medications. Maruthur and colleagues have addressed this question through a recently published systematic review and meta-analysis, which assesses the effect of all commonly used glucose-lowering drug classes on long-term and intermediate outcomes.
This was a systematic review …