Saxagliptin 5mg / Dapagliflozin 10mg tablets

BackgroundThe incidence of type 2 diabetes mellitus (T2DM) in children and adolescents is increasing, yet there is limited information on the available pharmacological interventions to combat T2DM and prevent associated comorbidities.AimTo assess the effectiveness of current pharmacological treatments in managing T2DM in children and adolescents. The protocol of the study was registered in PROSPERO (CRD42022382165).MethodsSearches were performed in PubMed, EMBASE, Scopus, and ClinicalTrials.gov for publications between 1990 to September 2024 without language restrictions. Randomized control trials (RCTs) of pharmacotherapy in children and adolescents with T2DM (aged via RStudio, 'meta' and 'netmeta'.ResultsA total of 12 studies having low to moderate risk of bias with 1658 participants, and follow-up duration 12-52 weeks were included. In our network meta-analysis, compared to control(s), the reduction of HbA1c was significantly larger for dulaglutide [mean difference (MD), 95% confidence interval: -1.20, -2.12 to -0.28], followed by dapagliflozin (-0.94, -1.44 to -0.44), liraglutide (-0.91, -1.37 to -0.45), empagliflozin (-0.87, -1.40 to -0.34), exenatide (-0.59, -1.07 to -0.11) and linagliptin (-0.45, -0.87 to -0.02) while other drugs had little or no effect. While liraglutide was associated with a change in body weight [MD -2.41 (-4.68, -0.14) kg], no other drug treatment was associated with significant changes in body weight, BMI, and lipids. Apart from level 1 hypoglycemia with liraglutide [risk difference (RD): 0.20, 0.04-0.37] and minor adverse events with dulaglutide (RD: 0.24, 0.08-0.40), no other treatment was associated with excess risk of hypoglycemia or minor or major adverse events.ConclusionPharmacotherapy of T2DM with dulaglutide, dapagliflozin, liraglutide, empagliflozin, exenatide, and linagliptin in children is associated with modest reduction of HbA1c. Larger RCTs with longer follow-up durations are needed to guide better therapeutic decision making.

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Background/Objectives: Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder characterized by insulin resistance, impaired insulin secretion, and chronic hyperglycemia. Recent studies have identified microRNAs (miRNAs), a class of small non-coding RNAs that regulate gene expression at the post-transcriptional level, as modulators of pathways involved in T2DM pathophysiology. Dysregulated miRNA expression has been detected in various samples collected from patients with T2DM, implicating these molecules in disease onset and progression. Methods: We systematically searched PubMed, Scopus, and Web of Science for studies published from the earliest available records to 18 August 2025 using the following Boolean search terms: "miRNA AND gliclazide", "miRNA AND glibenclamide", "miRNA AND gliquidone", "miRNA AND glimepiride", "mirRNA AND metformin", "miRNA AND pioglitazone", "miRNA AND rosiglitazone", "miRNA AND sitagliptin", "miRNA AND vildagliptin", "miRNA AND alogliptin", "miRNA and saxagliptin", "miRNA AND linagliptin", "miRNA AND liraglutide", "miRNA and dulaglutide", "miRNA AND semaglutide", "miRNA AND tirzepatide", "miRNA AND lixisenatide", "miRNA AND empagliflozin", "miRNA AND dapagliflozin", miRNA AND insulin glargine", "miRNA AND insulin detemir", "miRNA AND insulin degludec", "miRNA AND insulin aspart", "miRNA AND insulin glulisine", and "miRNA AND insulin lispro". Additionally, gray literature was searched in ClinicalTrials.gov, the EU Clinical Trials Register (EudraCT), and the ISRCTN Registry to identify unpublished studies. Studies were eligible for inclusion if they were clinical interventional studies assessing the impact of currently available antidiabetic treatments on miRNA expression. Only articles published in English were considered. The risk of bias was evaluated using the RoB2 (Risk of Bias 2) and ROBINS-I (Risk Of Bias In Non-randomized Studies-of Interventions) tools. Study characteristics and major findings were tabulated. Results: A total of 1263 manuscripts was identified initially. After removing duplicates, 726 articles remained for further screening. Ultimately, 17 manuscripts reporting interventional clinical trials on the effects of antidiabetic treatment on miRNA were included, encompassing a total of 1093 patients. Key findings included treatment-associated changes in miRNA expression and their potential utility for the prediction of clinical outcomes. Conclusions: Current evidence supports the hypothesis that antidiabetic treatments modulate miRNA expression, with some findings showing predictive value for metabolic outcomes. However, the available data remain limited and of low grade of certainty, and further large-scale clinical studies are needed to provide deeper insights into these associations.

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BackgroundA number of novel antidiabetic drugs have been developed. These drugs include sodium-glucose cotransporter 2 inhibitors (SGLT-2is), glucagon-like peptide-1 receptor agonists (GLP-1RAs), and dipeptidyl peptidase-4 inhibitors (DPP-4is). However, the optimal medication for individuals with type 2 diabetes mellitus (T2DM) and comorbid chronic kidney disease (CKD) has not been established. To this end, this study was conducted to compare specific novel antidiabetic drugs regarding efficacy and safety.MethodsPubMed, Embase, Cochrane Library, and Web of Science databases were searched for publications dated as of July 9, 2025. Cochrane risk of bias tool version 2.0 (RoB 2.0) was applied to measure the quality of the publications, and R 4.2.2 and Stata 15.1 were used to execute a Bayesian network meta-analysis (NMA). Primary outcomes encompassed major adverse cardiovascular events (MACEs), composite renal outcomes, and all-cause mortality (ACM). Secondary outcomes comprised adverse events (AEs), hypoglycemia, and cardiovascular death.ResultsThis NMA incorporated 30 studies, involving 39,844 participants with T2DM and comorbid CKD. The interventions were ranked by performance in various outcomes using the surface under the cumulative ranking curve (SUCRA) values. Sotagliflozin ranked first in reducing MACEs (SUCRA: 90.57%). Empagliflozin ranked first in improving composite renal outcomes (SUCRA: 89.76%) and reducing ACM (SUCRA: 72.38%). Canagliflozin ranked first in reducing AEs (SUCRA: 83.37%). Dapagliflozin + exenatide ranked first in reducing hypoglycemic events (SUCRA: 77.74%). Semaglutide ranked first in reducing cardiovascular mortality (SUCRA: 89.46%).ConclusionNovel antidiabetic drugs offer benefits for patients with T2DM and comorbid CKD. However, the optimal intervention varies for different outcomes. Further clinical studies are anticipated to validate these findings.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420251146144.

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BackgroundAsthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) accounts for 15-25% of chronic obstructive airway disease and is linked to frequent exacerbations and excess mortality. Newer glucose-lowering drugs may affect respiratory outcomes, but agent-level and dose-specific effects on ACOS are uncertain.MethodsWe searched PubMed, Embase, Cochrane CENTRAL, Web of Science, ClinicalTrials.gov, ClinicalKey, ScienceDirect, and ProQuest from inception to April 03, 2026, with an initial search on Dec 12, 2024. Eligible studies were randomised controlled trials in adult participants receiving eligible glucose-lowering therapies and systematically recording ACOS-related, asthma, or COPD events during follow-up. Trials compared dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, sodium-glucose cotransporter 2 (SGLT2) inhibitors, and other eligible antidiabetic regimens against standard care and/or placebo control. Risk ratios (RRs) with 95% CIs were estimated relative to this control group for ACOS, asthma, and COPD outcomes. Heterogeneity was assessed using tau-squared and I 2 statistics, and small-study effects/publication bias were assessed using comparison-adjusted funnel plots and Egger's regression. Outcome was trial-reported ACOS-related respiratory events. This study is registered with PROSPERO, CRD42024626613.FindingsCanagliflozin (RR 0.62, 95% CI 0.40-0.97), empagliflozin (0.70, 0.51-0.95), dapagliflozin (0.76, 0.63-0.92), and injectable semaglutide (0.64, 0.49-0.84) were associated with lower ACOS risk than control. Dose-stratified analyses suggested stronger associations for selected regimens, with signals more evident in participants with diabetes. Dapagliflozin was associated with lower asthma risk, whereas canagliflozin, empagliflozin, and injectable semaglutide were associated with lower COPD risk. Saxagliptin was associated with higher asthma risk (2.09, 1.01-4.33). No major heterogeneity, inconsistency, or small-study effects were detected.InterpretationRespiratory associations of newer glucose-lowering therapies were heterogeneous and agent specific. Selected SGLT2 inhibitors and injectable semaglutide were associated with lower ACOS-related risk, whereas saxagliptin may warrant caution in people prone to asthma. These findings support further prospective evaluation.FundingTaiwan National Science and Technology Council.

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