Summary

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• This summary is based on the review of 12 systematic review(s)/meta-analysis(es). ^[1-12]
• Glycemic Control: Dipeptidyl peptidase-4 (DPP-4) inhibitors, including sitagliptin, reduce hemoglobin A1c (HbA1c) by 0.5% to 1.0% when used as monotherapy, with additional reductions observed in combination therapy. Compared to sitagliptin, semaglutide achieved a greater reduction in HbA1c (weighted mean difference (WMD): -0.98; 95% confidence interval (CI): -1.28, -0.69), and teneligliptin demonstrated superior efficacy in lowering HbA1c and fasting plasma glucose.
• Cancer Risk: DPP-4 inhibitors are not associated with an increased risk of overall cancer, with evidence indicating a lower risk of colorectal cancer (Mantel-Haenszel Test and Odds Ratio (MH-OR) 0.70 [0.53, 0.94], p = 0.020).
• Cardiac Reverse Remodeling: Sitagliptin showed minimal impact on cardiac dimensions over a 24-month period, while liraglutide exhibited significant improvements in cardiac remodeling outcomes.
• Fracture Risk: Sitagliptin may reduce the risk of fractures, with an observed odds ratio of 0.495 (95% CI: 0.304-0.806), indicating a potential protective effect on bone health.
• DPP-4 inhibitors, including sitagliptin, are generally well-tolerated, with no serious safety signals except for saxagliptin, which is associated with an increased risk of hospitalization for heart failure.
• Sitagliptin demonstrates no significant safety concerns in relation to hypoglycemia or gastrointestinal adverse events when compared to placebo, and is comparable to other DPP-4 inhibitors regarding adverse effects.
• Studies included type 2 diabetes mellitus (T2DM) patients, with specific subgroup analyses focused on diabetic women with cancers (breast, ovarian, cervical, endometrial), cardiac patients evaluating cardiac dimensions, and T2DM patients assessed for fracture risk with sitagliptin, showing findings of reduced cervical cancer cell adhesion in vitro, minimal impact on cardiac remodeling, and a possible protective effect against fractures.