Comparative efficacy and safety of 8 GLP-1RAs in patients with type 2 diabetes: A network meta-analysis

Lin, Xia; Shen, Tiantian; Dong, Wanli; Su, Feng; Wang, Jiaxue; Wang, Qian; Niu, Suping; Fang, Yi

doi:10.1016/j.diabres.2021.108904

Cited by 24 publications

(19 citation statements)

References 47 publications

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“…In terms of hypoglycemic events, compared with placebo and semaglutide 1.0mg, except for semaglutide 2.4mg, which was significantly different, other pairwise comparisons had no statistical significance. However, this result is different from that of Lin Xia 36 et al reported liraglutide 1.8mg and semaglutide 1.0mg in the hypoglycemic events and weight loss. The final result shows that the more weight loss, the greater the incidence of adverse events.…”

Section: Discussioncontrasting

confidence: 92%

Efficacy and Safety of Liraglutide and Semaglutide on Weight Loss in People with Obesity or Overweight: A Systematic Review

Xie¹,

Yang²,

Deng³

et al. 2022

CLEP

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Purpose The effect and safety of Semaglutide and Liraglutide on weight loss in people with obesity or overweight were evaluated by a Network Meta-Analysis system to provide an evidence-based reference for clinical treatment. Methods Computer searched PubMed, Embase, and Cochrane Library databases to collect Liraglutide and Semaglutide injection monotherapy RCTs until April 2022, using Stata 16 software for Network Meta-Analysis. Results Twenty-three RCTs study with 11,545 patients and 4 interventions (semaglutide 2.4mg, semaglutide 1.0mg, liraglutide 3.0mg and liraglutide 1.8 mg) were finally included. In terms of efficacy, semaglutide 2.4mg (−12.47 kg) had the best weight loss, followed by liraglutide 3.0mg (−5.24 kg), semaglutide 1.0mg (−3.74 kg) and liraglutide 1.8mg (−3.29 kg). In terms of decreased HbA1c, semaglutide 2.4mg (MD=−1.48%, 95% CI [−1.93, −1.04]), semaglutide 1.0mg (MD=−1.36%, 95% CI [−1.72, −1.01]), liraglutide 1.8mg (MD=−1.23%, 95%Cl [−1.66, −0.80]) more effective than placebo. In terms of safety, the total incidence of adverse events was semaglutide 2.4mg > liraglutide 3.0mg > liraglutide 1.8mg > semaglutide 1.0mg compare to placebo, the incidence of serious adverse events was liraglutide 3.0mg > liraglutide 1.8mg > semaglutide 2.4mg > semaglutide 1.0mg, the incidence of hypoglycemic events was semaglutide 2.4mg > liraglutide 3.0mg > semaglutide 1.0mg > liraglutide 1.8mg. Conclusion This meta-analysis indicates that all GLP-1RAs were more efficacious than placebo in people with obesity or overweight on efficacy. Semaglutide 2.4mg has an absolute advantage in weight loss and decreased HbA1c, but the incidence of total adverse events is also the highest and can cause hypoglycemia. In addition, although liraglutide 3.0mg was less effective than semaglutide 2.4mg, serious adverse events were still the most elevated.

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Section: Discussioncontrasting

confidence: 92%

Efficacy and Safety of Liraglutide and Semaglutide on Weight Loss in People with Obesity or Overweight: A Systematic Review

Xie¹,

Yang²,

Deng³

et al. 2022

CLEP

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“…According to a previous within-study-level study [ 11 ] and between-study-level network meta-analysis [ 58 ], GLP1 RAs showed a higher efficacy for glycemic control, and a compatible higher efficacy for weight reduction is expected. The ecological fallacy in our pooled negative associations between glycemic control and weight reduction may be partially explained by a publication bias, but was better explained by a higher coefficient of variation of GLP-1 RAs for reducing body weight than HbA1c levels and the underlying glucose level [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of glucagon-like peptide-1 receptor agonists on glycemic control, and weight reduction in adults: A multivariate meta-analysis

Yeh

Tsai

et al. 2023

PLoS ONE

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Aims To explore the effect of glucagon-like peptide-1 receptor agonist (GLP-1 RAs) on glycemic control and weight reduction in adults. Methods Databases were searched from August 2021 to March 2022. Data were analyzed using mean difference (MD) values with 95% confidence intervals (CIs). Both random-and fixed-effect models were employed. Heterogeneity was explored using pre-specified subgroup analyses and meta-regression. Structural equation modeling fitting was used for the multivariate meta-analysis. Results A total of 31 double-blind randomized controlled trials with 22,948 participants were included in the meta-analysis. The MD and 95% CI of the pooled GLP1-RA-induced change in the glycated hemoglobin level was -0.78% (-0.97%, -0.60%) in the random-effects model and -0.45% (-0.47%, -0.44%) in the fixed-effect model, with a high heterogeneity (I2 = 97%). The pooled body weight reduction was -4.05 kg (-5.02 kg, -3.09 kg) in the random-effects model and -2.04 kg (-2.16 kg, -1.92 kg) in the fixed-effect model (I2 = 98%). The standardized pooled correlation coefficient between HbA1c levels and body weight was -0.42. A negative correlation between glycemic control and weight reduction was obtained. Conclusion Long-acting GLP-1 RAs significantly reduced the glycated hemoglobin level and body weight in adults.

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“…In contrast, dulaglutide and albiglutide are both large molecules, and could be sterically hindered, because of their size, to access GLP‐1 receptors at certain sites [86]. In agreement, the side effects of the two were often described as being weaker, and their effects on food intake less pronounced (supporting the view that the appetite effects are exerted centrally whereas the glycemic effects are peripheral) [87]. In contrast, the fenestrae of the capillaries in the islets seem to be sufficiently wide to allow access to these large molecules.…”

Section: Actions Of the Glp‐1 Receptor Agonistsmentioning

confidence: 99%

Glucagon‐like peptide‐1: Are its roles as endogenous hormone and therapeutic wizard congruent?

Holst

2022

J Intern Med

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Comparative efficacy and safety of 8 GLP-1RAs in patients with type 2 diabetes: A network meta-analysis

Cited by 24 publications

References 47 publications

Efficacy and Safety of Liraglutide and Semaglutide on Weight Loss in People with Obesity or Overweight: A Systematic Review

Efficacy and Safety of Liraglutide and Semaglutide on Weight Loss in People with Obesity or Overweight: A Systematic Review

Effect of glucagon-like peptide-1 receptor agonists on glycemic control, and weight reduction in adults: A multivariate meta-analysis

Glucagon‐like peptide‐1: Are its roles as endogenous hormone and therapeutic wizard congruent?

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