Efficacy and safety of ranolazine in the treatment of type 2 diabetes mellitus：a Meta-analysis

Abstract:

Objective：To evaluate the efficacy and safety of ranolazine in the treatment of diabetes mellitus type 2 （T2DM）. Methods：CENTRAL，Medline，EMbase，CNKI，VIP，CBM，Wanfang database，WHO Clinical Trials Registry Platform and ClinicalTrials.gov were searched. The quality of included randomized controlled trials was assessed according to the Cochrane Collaboration system review，and then Meta-analysis was performed using RevMan 5.2. Results：A total of 7 randomized controlled trials（RCTs） were enrolled in－cluding 3 131 patients. Meta-analysis showed that ranolazine（1 000 mg bid） monotherapy compared with placebo resulted in a signif－icant reduction in HbA1c（MD=-0.55，95%CI=-0.73 to -0.37，P=0.000），in FPG（SMD=-0.19，95%CI=-0.37 to -0.01，P=0.04），in 2hPG（SMD=-0.34，95%CI=-0.53 to -0.15，P=0.000 5）. As an add-on interaction with antidiabetes compared with placebo，ranolazine（1 000 mg bid） resulted in a significant reduction in glycosylated hemoglobin（HbA1c）（MD=-0.47，95%CI=-0.62 to -0.32，P=0.000），a similar reduction in fasting blood-glucose （FPG）（SMD=-0.00，95%CI=-0.21 to 0.20，P=0.97），in postprandial 2 hours blood glucose（2hPG）（SMD=-0.12，95%CI=-0.33 to 0.09，P=0.28），ranolazine（750 mg bid） resulted in a significant reduction in HbA1c（MD=-0.48，95%CI=-0.85 to -0.11，P=0.01），a similar reduction in FPG（SMD=0.11，95%CI=-0.26 to 0.48，P=0.57）. When add-on to antidiabetes ranolazine（500 mg bid） compared with trimetazidine elicited a similar reduction in HbA1c（MD=-0.30，95%CI=-1.35 to 0.75，P=0.58），in FPG（SMD=-0.36，95%CI=-0.94 to 0.22，P=0.22），in 2hPG（SMD=0.15，95%CI=-0.42 to -0.73，P=0.60）. Ranolazine didn’t increase the risk of hypoglycemia（RR=1.24，95%CI=0.80 to 1.93，P=0.34）. Conclusion：Ranolazine can effectively reduce HbA1c level by inhibiting glucagon secretion and safe for adults with T2DM.