The effectiveness and safety of linagliptin within elderly type 2 diabetes mellitus: a meta-analysis and systematic review.

Background: Linagliptin is a convenient and effective drug approved for glycemic management in type 2 diabetes mellitus (T2DM). However, the effectiveness and safety evidence of linagliptin remains unclear with the increasing prevalence of T2DM in elderly patients.

Objective: For evaluating the effectiveness and safety of linagliptin within T2DM cases who aged ≥60 years.

Methods: The researchers pooled 4903 cases aged ≥60 years with T2DM from 5 published randomized clinical trials obtained from multiple databases. The safety was evaluated by the incidence and severity of adverse events (AEs) which mainly focused on hypoglycaemia. The major effectiveness end point was the change of glycated haemoglobin (HbA1c). Then the researchers made the qualitative and quantitative assessments of the investigation.

Results: The level of HbA1c and FPG was significantly reduced by linagliptin (WMD=-0.63%, 95% CI: -0.81, -0.44; p<0.00001; Z=6.70) and (WMD=-15.58 mg/dL, 95% CI: -22.34, -8.82; p<0.00001; Z=4.52) relative to that in the placebo cohort. The incidences of overall (OR=1.01, 95% CI: 0.82, 1.25; p=0.91) and severe negative events (OR=0.88, 95% CI: 0.61, 1.25; p=0.46) were not significant increased in linagliptin cohorts compared to the placebo cohorts. There is insignificant difference in hypoglycaemia between linagliptin and placebo cohorts for the 24 weeks' study(OR=1.12, 95% CI: 0.85, 1.48; p=0.41). Severe hypoglycemia had slightly descended incidence, whereas insignificant difference was shown in the linagliptin cohorts in contrast to placebo cohorts (OR=0.95, 95 % CI: 0.68, 1.32, p=0.76).

Conclusions: Linagliptin is an effective drug with excellent safety for elderly T2DM.