Efficacy and safety of oral semaglutide in type 2 diabetes mellitus: A systematic review and meta-analysis. (April 2023)

• Record Type: Journal Article
• Authors: Li, Aihua; Su, Xiaorong; Hu, Shanshan; Wang, Yong
• Is Part Of: Diabetes research and clinical practice. Volume 198(2023)
• Publication Date: 2023-04
• Subjects: Oral semaglutide -- Meta-analysis -- Type 2 diabetes mellitus -- Systematic review; GLP-1 Glucagon-like peptide-1 -- T2DM Type 2 diabetes mellitus -- RCTs Randomized controlled trials -- CVOT Cardiovascular outcome trials -- GLP-1RA GLP-1 receptor agonists -- OADs Oral antidiabetic drugs -- GIP Glucose-dependent insulinotropic polypeptide -- SGLT-2i Sodium-dependent glucose transporters-2 inhibitors -- DPP-4i Dipeptidyl peptidase-4 inhibitors -- HbA1c Hemoglobin A1c -- FPG Fasting plasma glucose -- SMPG SMPG-Mean 7-Point Profile -- SBP Systolic blood pressure -- DBP Diastolic blood pressure -- AE Adverse events -- SAE Serious adverse events -- RR Risk ratios -- MD Mean differences -- CIs Confidence intervals; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2023.110605
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Objectives: To investigate the efficacy and safety of oral semaglutide 7 and 14 mg, the only orally delivered glucagon-like peptide-1 (GLP-1) receptor agonist tablet approved for type 2 diabetes mellitus (T2DM) patients. Methods: Search several databases for randomized controlled trials (RCTs) of oral semaglutide in patients with T2DM from inception through May 31, 2021. The primary outcomes included change from baseline in hemoglobin A1c (HbA1c) and body weight. Risk ratios (RR), mean differences (MD), and 95% confidence intervals (CI) were calculated to evaluate the outcomes. Results: This meta -analysis included 11 RCTs with a total of 9821 patients. Compared with placebo, semaglutide 7 and 14 mg reduced HbA1c by 1.06% (95% CI, 0.81–1.30) and 1.10% (95% CI, 0.88–1.31), respectively. While in comparison with other antidiabetic agents, semaglutide 7 and 14 mg reduced HbA1c by 0.26% (95% CI, 0.15–0.38) and 0.38% (95%CI, 0.31–0.45). Both doses of semaglutide could significantly reduce body weight. Semaglutide 14 mg did increase the incidence of medication discontinuation and gastrointestinal events (nausea, vomiting and diarrhea). Conclusion: Once-daily semaglutide 7 and 14 mg can significantly lowered HbA1c and body weight in patients with T2DM, and this effect increases with dose. Significantly, more gastrointestinal events occurred with semaglutide 14 mg.