What question did this study set out to answer?

The central aim is to evaluate the effectiveness, safety, and cost-utility of DPP-4 inhibitors combined with metformin compared to metformin alone.

April 4, 2026Open Access

Comparative Efficacy, Safety, and Cost‐Utility of DPP‐4 Inhibitors and Metformin Combination Therapy in Type 2 Diabetes: A Systematic Review of Real‐World Clinical and Economic Outcomes

Key Points

The central aim is to evaluate the effectiveness, safety, and cost-utility of DPP-4 inhibitors combined with metformin compared to metformin alone.
Conducted a systematic review of real-world clinical data
Analyzed economic outcomes and cost-effectiveness
Compared HbA1c reductions between treatments
DPP-4 inhibitors combined with metformin reduce HbA1c levels significantly
Cost-effectiveness is lower compared to metformin monotherapy and free drugs
Initiating treatment with metformin alone is recommended for better patient adherence

Abstract

DPP-4 inhibitors/metformin demonstrate significant HbA1c reduction, but their low cost-effectiveness hinders patient adherence compared to metformin monotherapy, free drugs, or other combinations. For that, initiating therapy with cost-effective metformin alone is recommended. Manufacturer-funded trials highlight a potential bias, necessitating independent research validations.

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