Comparative efficacy and safety of 8 GLP-1RAs in patients with type 2 diabetes: A network meta-analysis. (July 2021)

• Record Type: Journal Article
• Authors: Xia, Lin; Shen, Tiantian; Dong, Wenliang; Su, Feng; Wang, Jiaxue; Wang, Qian; Niu, Suping; Fang, Yi
• Is Part Of: Diabetes research and clinical practice. Volume 177(2021)
• Publication Date: 2021-07
• Subjects: GLP-1RAs -- Type 2 diabetes -- Efficacy -- Safety -- A network meta-analysis; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2021.108904
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Aims: To inform clinical practice by comparing and ranking the lowing blood glucose and weight-loss abilities of 8 glucagon-like peptide-1 receptor agonists (GLP-1RAs) in patients with type 2 diabetes (T2D). Methods: We searched PubMed, EMBASE, and CENTRAL from database inception to April 13, 2021. The outcomes were Δ HbA1c, Δ weight, adverse events [AE] withdrawals, and incidence of hypoglycemia. We estimated standardized mean differences [SMD] and summary odds ratios (ORs) using frequentist network meta-analysis with random effects. Results: Retrieved trials included 11, 126 patients, the overall mean age was 56.7 ± 10.36 years old. In terms of efficacy, all GLP-1RAs were more effective than the placebo except albiglutide-30 mg QW (Δ weight: SMD −0.26 kg [95 %CI: −1.10, 0.59 kg). When it came to safety, oral semaglutide-14mgQD, semaglutide-1mgQW, Liraglutide-1.8mgQD, and Exenatide-2ugBID were associated with an increased risk of AE withdrawals. And GLP-1RAs were associated with a higher incidence of hypoglycemia than placebo except albiglutide-30mgQW and orally administered semaglutide-14mgQD. Conclusion: Overall GLP-1RAs were more efficacious than placebo in patients with T2D on efficacy. Unfortunately, differences between GLP1-RAs regarding safety were mostly not significant. We may realize the individualized GLP-1RAs administration based on blood glucose level and obesity degree.