Efficacy and safety of sodium‐glucose cotransporter‐2 inhibitors versus dipeptidyl peptidase‐4 inhibitors as monotherapy or add‐on to metformin in patients with type 2 diabetes mellitus: A systematic review and meta‐analysis

Aims To compare the efficacy and safety of dipeptidyl peptidase‐4 inhibitors (DPP‐4is) and sodium‐glucose cotransporter‐2 inhibitors (SGLT‐2is) as monotherapy or add‐on to metformin (Met) in patients with type 2 diabetes mellitus (T2DM). Materials and Methods PubMed, Embase and ClinicalTrials.gov sites were systematically searched for randomized controlled trials to assess the efficacy and safety of DPP‐4is and SGLT‐2is in patients with T2DM. Risk ratio (RR) and weighted mean difference (WMD) were used to evaluate outcomes. Results In the analysis of 25 randomized trials, which involved 14 619 patients, SGLT‐2is were associated with a significantly stronger reduction in haemoglobin A1c (HbA1c) (WMD 0.13%, 95% credible interval [CI], 0.04%‐0.22%, P = .005) and fasting plasma glucose (FPG) (WMD 0.80 mmol/L, 95% CI, 0.58‐1.01 mmol/L, P