Comparison and Evaluation of Efficacy and Safety of Sitagliptin and Linagliptin in Adults With Type 2 Diabetes Mellitus: A Bayesian Network Meta-Analysis.

AIM: A Bayesian network meta-analysis of available randomized controlled trials (RCTs) was conducted to systematically evaluate and compare the efficacy and safety of sitagliptin and linagliptin in treating adults with type 2 diabetes mellitus (T2DM). METHODS: PubMed, Web of Science, Cochrane Library, Embase, ClinicalTrials.gov, Scopus, CNKI, VIP, WanFang, and CBM were searched from inception to October third, 2025. RCTs evaluating the efficacy or safety of sitagliptin or linagliptin in treating adults with T2DM were included, with a follow-up duration of at least 12 weeks and a minimum sample size of 30 participants per treatment group. This study employed a Bayesian random-effects model to calculate relative effect measures with 95% credible intervals (CrIs). Of these, RCTs with outcome assessment at 24 to 54 weeks were incorporated into the primary analysis, and the rest into the sensitivity analysis. The risk of bias was assessed using the Cochrane Risk of Bias Tool (2.0). The certainty of evidence was evaluated using the Confidence in Network Meta-Analysis framework. This study was pre-registered on the International Prospective Registry of Systematic Reviews (No. CRD42024500280). RESULTS: A total of 87 RCTs involving 64,517 participants were included. Among them, 61 RCTs with 28,715 participants were included in the primary analysis. Compared with placebo, both sitagliptin 100 mg/day and linagliptin 5 mg/day demonstrated significantly superior efficacy in reducing hemoglobin A CONCLUSION: Sitagliptin 100 mg/day and linagliptin 5 mg/day demonstrated favorable and equivalent antidiabetic efficacy and safety profiles. However, neither was significantly superior to the other included antidiabetic drugs on glycemic control.