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| Study, study origin | Quality score | Inclusion criteria | Design and duration (week) | Intervention/day | n |
|
| | TZDs versus DPP IV inhs. | | |
|
(i) Scott et al. [22]
Australia, India, Italy, Malaysia, New Zealand, Poland, Sweden | 3 | (i) T2DM
(ii) A1c 7–11%
(iii) Taking metformin monotherapy ≥1,500 mg/day for ≥10 weeks
(iv) Aged 18–75 years | DP (18) | (i) Rosiglitazone 8 mg OD + metformin (≥1,500 mg/day) usual dose
(ii) Sitagliptin 100 mg OD + metformin (≥1,500 mg/day) usual dose | (i) 87
(ii) 94 |
|
(ii) Bolli et al. [23]
Australia, Austria, Germany, Italy, UK, USA, South Africa, Spain | 3 | (i) T2DM
(ii) A1c 7.5–11.0%
(iii) Receiving metformin alone ≥1,500 mg/day
(iv) Aged 18–77 years
(v) Male and female (non-fertile or of childbearing potential using a medically approved birth control method)
(vi) BMI 22–45 kg/m2
(vii) FPG < 15 mmol/L | DP (52) | (i) Pioglitazone 30 mg OD + metformin (≥1,500 mg/day) usual dose
(a) mean metformin dose 2,020 mg
(ii) Vildagliptin 50 mg bid + metformin (≥1,500 mg/day) usual dose
(a) mean metformin dose 2,020 mg | (i) 281
(ii) 295 |
|
| | TZDs versus SUs | | |
|
(i) Charbonnel et al. [24]
29 European countries, Australia, Canada, South Africa | 5 | (i) T2DM
(ii) A1c 7.5–11.0%
(iii) Managed with metformin monotherapy (≥50% of the maximum recommended dose or maximum tolerated dose) for ≥12 weeks
(iv) Aged 35–75 years
(v) Fasting C-peptide levels ≥0.50 nmol/L (1.5 ng/mL)
(vi) Stable or worsening glycemic control for ≥3 months | DP (104) | (i) Pioglitazone 15–45 mg (titrated) + metformin (>50% maximum dose or max-tolerated dose) usual dose
(a) Mean metformin dose 1,726 mg
(b) Mean pioglitazone dose 39 mg
(ii) Gliclazide 80–320 mg + metformin (>50% maximum dose or max-tolerated dose) usual dose
(a) Mean metformin dose 1,705 mg
(b) Mean gliclazide 212 mg | (i) 317
(ii) 313 |
|
(ii) Garber et al. [25]
USA | 4 | (i) T2DM
(ii) A1c > 7.0 and ≤12.0%
(iii) On metformin monotherapy ≥1,500 mg/day for ≥8 weeks
(iv) Aged 20–78 years
(v) BMI 23–45 kg/m2
(vi) Willing and able to perform SMBG
(vii) Female of childbearing potential had to practise acceptable methods of birth control and to have negative pregnancy test results within 72 hours of study treatment | DP (24) | (i) Used metformin 1,500 mg: metformin 1,500–2,000 mg (titrated) + rosiglitazone 4–8 mg (titrated)
(ii) Used metformin >1,500 mg: metformin 2000 mg + rosiglitazone 4–8 mg (titrated)
(a) Mean final metformin/rosiglitazone dose 1,819/7.1 mg
(iii) Metformin-glibenclamide 1,000–2,000/5–10 mg
(a) Mean final metformin/glibenclamide dose 1,509/7.6 mg | (i) 158
(ii) 160 |
|
(iii) Umpierrez et al. [26]
USA | 2 | (i) Diagnosed of T2DM at least 6 months
(ii) A1c 7.5–10%
(iii) Treated with metformin (1–2.5 g/d) or extended-release metformin alone (0.5–2.0 g/d) for ≥8 weeks
(iv) Aged 18–79 years
(v) BMI ≥ 24 kg/m2
(vi) FPG 126–235 mg/dL
(vii) Fasting C-peptide ≥ 0.27 nmol/L | OP (26) | (i) Pioglitazone 30–45 mg (titrated) + metformin usual dose
(a) Mean final metformin dose 1,570 mg
(ii) Glimepiride 2–8 mg (titrated) + metformin usual dose
(a) Mean final metformin dose 1,490 mg | (i) 109
(ii) 101 |
|
(iv) Hamann et al. [27]
Europe, Mexico | 4 | (i) Male and female with T2DM
(ii) A1c 7–10%
(iii) Having received metformin (≥0.85 g/day) for ≥8 weeks
(iv) BMI ≥ 25 kg/m2 | DP (52) | (i) Rosiglitazone 4–8 mg (titrated) + metformin 2,000 mg
(a) Mean final dose of rosiglitazone/metformin 7.7/2,000 mg
(ii) Glibenclamide 5–15 mg (titrated) + metformin 2,000 mg
(iii) Gliclazide 80–320 mg (titrated) + metformin 2,000 mg
(a) Mean final dose of glibenclamide/metformin 11/2,000 mg
(b) Mean final dose of gliclazide/metformin 238.1/2,000 mg | (i) 294
(ii) 302 |
|
|
| | TZD versus TZD | | |
|
(i) Derosa et al. [28]
Italy | 5 | (i) T2DM duration ≥6 months
(ii) A1c > 7.5% or had adverse effects with diet and metformin (administered up to the maximum tolerated dose)
(iii) Caucasian patients aged ≥18 years
(iv) BMI 25.0–28.1 kg/m2
(v) Diagnosed with metabolic syndrome according to the NCEP Treatment Panel III
(vi) TG ≥ 150 mg/dL
(vii) Hypertension according to the WHO criteria (blood pressure, ≥130/≥85 mmHg)
(viii) Fasting C-peptide > 1.0 ng/mL | DP (48) | (i) Pioglitazone 15 mg + metformin 1,500–3,000 mg (titrated)
(a) Mean metformin dose 2,250 ± 750 mg
(ii) Rosiglitazone 4 mg OD + metformin 1,500–3,000 mg (titrated)
(a) Mean metformin dose 2,250 ± 750 mg | (i) 48
(ii) 48 |
|
| | Insulin versus SU | | |
|
(i) Kvapil et al. [29]
Croatia, Czech Republic, Denmark, France, Greece, Hungary, Norway, Poland, Portugal, Russia, Spain | 3 | (i) T2DM
(ii) Receiving ≥850 mg metformin monotherapy for ≥4 weeks | OP (16) | (i) BIAsp 30 was 0.2 U/kg body weight (could be titrated) + metformin (maximum tolerated or maximum effective dose, titrated)
(a) Mean metformin dose 1,660 mg
(ii) Glibenclamide 1.75–10.5 mg (titrated) + Metformin (maximum tolerated or maximum effective doses, titrated)
(a) Mean metformin dose 1,660 mg | (i) 116
(ii) 114 |
|
