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Dipeptidyl Peptidase IV Inhibitors for Nonalcoholic Fatty Liver Disease - Systematic Review and Metanalysis

Author(s):

Lucas Ribeiro dos Santos*, Marcio Luis Duarte, Maria Stella Peccin, Antônio Ricardo de Toledo Gagliardi and Tamara Melnik   Pages 1 - 12 ( 12 )

Abstract:


Introduction: Hepatic steatosis is a frequent condition, that afflicts, especially, obese and insulin resistant patients; diagnosis is made, usually, through imaging tests. Despite the high prevalence and risk of complications, there is no specific treatment approved, though a vast number of medications have been tested.

Objective: To determine the efficacy of dipeptidyl peptidase IV inhibitors (i DPP-IV) in the treatment of NAFLD.

Methods: We searched the electronic databases of the Cochrane Library, MEDLINE, EMBASE and LILACS, as well as reference lists of the included studies and grey literature; 9 studies were selected for inclusion.

Results: 7 studies were used for metanalysis, for 3 outcomes. i DPP-IV showed an ALT-reducing power of MD -10.83 [95% CI 35.23 to 13.57] at 3 months and MD -9.27 [95% CI 10.92 to -7.62] at 6 months of intervention, as well as reduction of hepatic steatosis via MRI of SMD 0.10 [95% CI 0.31 to 0.50]; the overall incidence of adverse events was very low. The studies were considered of low and very low quality by the GRADE evaluation.

Conclusion: Because of the poor overall quality of the studies and heterogeneity of the population analyzed, i DPP-IV did not show efficacy on inflammatory markers or fibrosis in patients with NAFLD.

Keywords:

Dipeptidyl-Peptidase IV Inhibitors, Fatty Liver, Steatohepatitis, Type 2 Diabetes Mellitus, Obesity, Systematic Review

Affiliation:

Faculty of Medical Sciences of Santos – Lusiada University, Department of Internal medicine. Santos/SP,, Federal university of São Paulo – UNIFESP, Evidence based medicine department. São Paulo/SP,, Federal university of São Paulo – UNIFESP, Evidence based medicine department. São Paulo/SP,, Angiocorpore – Cardiovascular institute of Santos. Santos/SP,, Federal university of São Paulo – UNIFESP, Evidence based medicine department. São Paulo/SP



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