Lin C, Li ZL, Cai XL, Hu SY, Lv F, Yang WJ, Ji LN. Indirect comparison of efficacy and safety of chiglitazar and thiazolidinedione in patients with type 2 diabetes: A meta-analysis. World J Diabetes 2023; 14(10): 1573-1584 [PMID: 37970134 DOI: 10.4239/wjd.v14.i10.1573]
Corresponding Author of This Article
Li-Nong Ji, MD, Professor, Department of Endocrinology and Metabolism, Peking University People’s Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing 100044, China. jiln@bjmu.edu.cn
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Chu Lin, Zong-Lin Li, Xiao-Ling Cai, Sui-Yuan Hu, Fang Lv, Wen-Jia Yang, Li-Nong Ji, Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing 100044, China
Author contributions: Ji LN and Cai XL were responsible for the study concept and designed the systematic review protocol; Lin C and Li ZL performed the study selection and data extraction; Lin C and Li ZL performed the statistical analyses; Lin C, Li ZL and Cai XL prepared the outlines and wrote the manuscript; All authors contributed to the critical revision of manuscript drafts.
Supported byBeijing Natural Science Foundation, No. 7202216; National Natural Science Foundation of China, No. 81970698 and No. 81970708.
Conflict-of-interest statement: LJ has received fees for lecture presentations and for consulting from AstraZeneca, Merck, Metabasis, MSD, Novartis, Eli Lilly, Roche, Sanofi-Aventis and Takeda. All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare. No other support from any organization for the submitted work other than that described above.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Nong Ji, MD, Professor, Department of Endocrinology and Metabolism, Peking University People’s Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing 100044, China. jiln@bjmu.edu.cn
Received: June 8, 2023 Peer-review started: June 8, 2023 First decision: July 18, 2023 Revised: July 22, 2023 Accepted: August 17, 2023 Article in press: August 17, 2023 Published online: October 15, 2023
ARTICLE HIGHLIGHTS
Research background
Chiglitazar as a pan-agonist of peroxisome proliferator activated receptor (PPAR)-α, δ and γ, has the potential to induce better glycemic and lipidemic control than the PPAR-γ agonist thiazolidinediones (TZDs) in patients with type 2 diabetes (T2D).
Research motivation
Currently, there are no clinical studies or meta-analyses comparing the efficacy and safety of chiglitazar and TZD. A meta-analysis is required to further address this topic.
Research objectives
To compare the efficacy and safety of chiglitazar and TZD in patients with T2D.
Research methods
Randomized controlled trials (RCTs) of chiglitazar or TZD vs placebo in patients with T2D were retrieved. Indirect comparisons and sensitivity analyses were implemented to evaluate the efficacy and safety endpoints of interest.
Research results
We included 93 RCTs comparing TZD with placebo and one comparing chiglitazar with placebo. For efficacy endpoints, the augmented dose of chiglitazar, compared with TZD, resulted in greater reductions in hemoglobin A1c, triglycerides and alanine aminotransferase levels, and greater homeostasis model assessment of β cell function elevation. For safety endpoints, the risks of hypoglycemia, edema, bone fractures, upper respiratory tract infection, urinary tract infection, and weight gain were all comparable between the augmented dose of chiglitazar and TZD.
Research conclusions
Chiglitazar, a pan-activator of PPARs, may exhibit preferable glycemic and lipid control, and β-cell function preservation, with no additional safety concerns with augmented doses compared with TZD in patients with T2D.
Research perspectives
Chiglitazar has potential for T2D treatment. However, more investigations evaluating safety outcomes of chiglitazar, especially heart failure, are still needed.
