Summary of findings for the main comparison. DPP‐4 inhibitors for prevention or delay of type 2 diabetes mellitus and its associated complications in people at risk for the development of type 2 diabetes mellitus.
| DPP‐4 inhibitors for prevention or delay of type 2 diabetes mellitus and its associated complications in people at risk for the development of type 2 diabetes mellitus | ||||||
|
Population: people at risk for development of T2DM Settings: outpatients Intervention: DPP‐4 inhibitors Comparison: placebo | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (trial(s)) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Placebo | DPP‐4 inhibitors | |||||
|
All‐cause mortality Follow‐up: 12 weeks |
See comment | See comment | See comment | 179 (1) | ⊕⊝⊝⊝ Very lowa | 1 trial on vildagliptin reported that none of the participants died (Rosenstock 2008) |
|
Incidence of T2DM Definition: WHO criteria Follow‐up: 12 weeks |
See comment | See comment | See comment | 179 (1) | ⊕⊝⊝⊝ Very lowa | 1 trial reported that 3/90 in the vildagliptin group vs 1/89 in the placebo group developed T2DM (Rosenstock 2008) |
|
Serious adverse events Follow‐up: 12 weeks |
See comment | See comment | See comment | 179 (1) | ⊕⊝⊝⊝ Very lowa | 1 trial reported that 1/90 in the vildagliptin group vs 2/89 in the placebo group experienced a serious adverse event (Rosenstock 2008) |
|
Cardiovascular mortality Follow‐up: 12 weeks |
See comment | See comment | See comment | 179 (1) | ⊕⊝⊝⊝ Very lowa | 1 trial reported that none of the participants died (Rosenstock 2008) |
|
(1) Non‐fatal myocardial infarction (2) Non‐fatal stroke (3) Congestive heart failure Follow‐up: 12 weeks |
See comment | See comment | See comment | (1) ‐ (2) ‐ (3) 179 (1) |
⊕⊝⊝⊝ Very lowa | (1) + (2): not reported (3): 1 trial on vildagliptin reported 1/90 in the vildagliptin group vs 0/89 in the placebo group experienced heart failure (Rosenstock 2008) |
| Health‐related quality of life | See comment | See comment | See comment | See comment | See comment | Not reported |
| Socioeconomic effects | See comment | See comment | See comment | See comment | See comment | Not reported |
| *The basis for the assumed risk (e.g. the median control group risk across trials) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; DPP‐4: dipeptidyl‐peptidase‐4; RR: risk ratio; T2DM: type 2 diabetes mellitus; WHO: World Health Organization. | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
*Assumed risk was derived from the event rates in the comparator groups.
aDowngraded by three levels because of indirectness, imprecision (very sparse data) and risk of publication bias (see Appendix 15).