The efficacy and safety of dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 agonists in pediatric patients with type 2 diabetes: a systematic review.

Background: The incidence of type 2 diabetes mellitus (T2DM) in the pediatric population is increasing. There is a great need to develop more drugs for pediatric T2DM. Glucagon-like peptide-1 (GLP-1) agonists and dipeptidyl dipeptidase-4 (DPP-4) inhibitors have been approved for adults with T2DM and they might be effective in youths due to the similar pathogenic defects associated with T2DM. Here we aim to evaluate the efficacy and safety of GLP-1 agonists and DPP-4 inhibitors in pediatric patients with T2DM.

Contents: We performed a systematic review including trials comparing GLP-1 agonists and DPP-4 inhibitors against placebo in pediatric T2DM. This project was conducted based on the quality of reporting of meta-analyses (QUOROM) statement. Embase, PubMed, and Cochrane library were searched by two independent investigators for selecting relevant studies.

Summary and outlook: Five RCTs with a total sample size of 237 children were included. GLP-1 agonists showed superiority in glycemic improvement than placebo for pediatric T2DM. The advantage of DPP-4 inhibitors versus placebo for glycemic improvement is still unclear. GLP-1 agonists and DPP-4 inhibitors were well tolerated in pediatrics and further strictly designed trials are needed.