Methodological concerns with the meta-analysis comparing insulin degludec/liraglutide and insulin glargine/lixisenatide

摘要

In a recent article published in Expert Opinion on Pharmacotherapy (Nov 5 2017), Cai and colleagues reported a systematic review and meta-analysis of randomized controlled trials of insulin degludec/liraglutide (IDegLira; Novo Nordisk) and insulin glargine/lixisenatide(IGlarLixi; Sanofi), both fixed ratio combinations (FRC) of a basal insulin and a glucagon-like peptide-1 receptor agonist (GLP-1RA) [1]. In the absence of head-to-head comparisons of drugs, meta-analyses can provide additional evidence not available from single trials; however, any conclusions must be based on proper methodology. Cai et al. [1] concluded that ‘Comparisons between the two treatment groups indicated no significant differences between groups in absolute HbA1c changes or body weight changes relative to baseline.’ We question the validity of these overall conclusions, based on concerns about both the heterogeneity of the trials included and the statistical methods used.