The Clinical Pharmacokinetics and Pharmacodynamics of Glimepiride-A Systematic Review and Meta-Analysis

Background/Objectives: Glimepiride (GLM), a commonly used sulphonylurea drug for the management of type 2 diabetes mellitus (T2DM), has been the subject of numerous studies exploring its kinetic behaviors. However, a comprehensive evaluation that synthesizes all available pharmacokinetic (PK) data across diverse populations remains limited. This systematic review aims to provide detailed knowledge about the pharmacokinetics (PK), the associated pharmacodynamics (PD), and the drug interactions of GLM, which can be used to assess key parameters and identify factors influencing variability across diverse populations and clinical settings. Methods: A systematic search of the peer-reviewed literature was combined using major databases-Google Scholar, PubMed, Cochrane, and ScienceDirect, to identify studies reporting the PK of GLM. Following the data extraction, a meta-analysis using a random effect (RE) model was performed, where feasible, to quantitatively assess the variability of key PK parameters across different studies to create a more robust PK parameter estimate. Results: The final screening has yielded 40 articles. The area under the curve (AUC_0-∞) and the peak concentration (C_max) rise proportionately with increasing doses, depicting the linear kinetics of GLM. The subjects with genotype CYP2C9 *1/*3 depicted a 4-fold higher (AUC_0-∞) as compared to that of the CYP2C9 *1/*1 population. Preliminary meta-analysis results indicated significant variability in (AUC_0-∞) and C_max values among different studies. Heterogeneity across studies was high, warranting the use of RE models. Conclusions: The findings of this review would be helpful in the development and evaluation of PK models that may aid in suggesting individualized dosing.