A Critical View over the Newest Antidiabetic Molecules in Light of Efficacy—A Systematic Review and Meta-Analysis

Abstract

The increase in life expectancy without a decrease in the years lived without disability leads to the rise of the population aged over 65 years prone to polypharmacy. The novel antidiabetic drugs can improve this global therapeutic and health problem in patients with diabetes mellitus (DM). We aimed to establish the efficacy (A1c hemoglobin reduction) and safety of the newest antidiabetic drugs (considered so due to their novelty in medical practice use), specifically DPP-4i, SGLT-2i, GLP-1 Ra, and tirzepatide. The present meta-analysis followed the protocol registered at Prospero with the CRD42022330442 registration number. The reduction in HbA1c in the DPP4-i class for tenegliptin was 95% CI −0.54 [−1.1, 0.01], p = 0.06; in the SGLT2-iclass for ipragliflozin 95% CI −0.2 [−0.87, 0.47], p = 0.55; and for tofogliflozin 95% CI 3.13 [−12.02, 18.28], p = 0.69, while for tirzepatide it was 0.15, 95% CI [−0.50, 0.80] (p = 0.65). The guidelines for treatment in type 2 DM are provided from cardiovascular outcome trials that report mainly major adverse cardiovascular events and data about efficacy. The newest antidiabetic non-insulinic drugs are reported to be efficient in lowering HbA1c, but this effect depends between classes, molecules, or patients’ age. The newest antidiabetic drugs are proven to be efficient molecules in terms of HbA1c decrease, weight reduction, and safety, but more studies are needed in order to characterize exactly their efficacy and safety profiles.

Customizable Click Biochemistry Strategy for the Design and Preparation of Glucagon-like Peptide-1 Conjugates and Coagonists

“…In recent years, only one GLP-1/GIP hybridized peptide, Tirzepatide, has been approved by the FDA and EMA, despite that there are more than 20 dual- or triagonists (choosing from GIP, GCG, or fibroblast growth factors 21 (FGF21)) entering clinical trials. − Our strategy enables the design of a broad spectrum of GLP-1-containing coagonists, such as GLP-1 with GCG, peptide YY (PYY), or FGF21, along with their variants, and additional peptide or protein partners such as the Fc fragment utilized in Dulaglutide. This versatility extends to the assembly of other diverse peptides or protein combinations.…”

Tetrazoles and Related Heterocycles as Promising Synthetic Antidiabetic Agents

“…Here, drug therapy is required to target the various biological mechanisms responsible for metabolic processes. A great deal of studies have been dedicated to the development of such drugs, and these studies are being intensively developed [3].…”

Functional and Clinical Importance of SGLT2-inhibitors in Frailty: From the Kidney to the Heart

“…GLT2 (sodium-glucose cotransporter 2) inhibitors (also known as gliflozins) are oral antidiabetic drugs that have emerged as a cornerstone to reach and keep glycemic control, [1][2][3][4] particularly in older adults. [5][6][7] SGLT2 is a cotransporter that induces glucose and sodium (Na + ) reabsorption in the kidney; hence, SGLT2inhibitors act interfering with this process, reducing glycemia.…”