Comparative effectiveness of GLP-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes: systematic review and network meta-analysis
Authors' conclusion
GLP-1RAs are efficacious in treating adults with type 2 diabetes. Compared with the placebo, tirzepatide was the most effective GLP-1RA drug for glycaemic control by reducing haemoglobin A1c and fasting plasma glucose concentrations. GLP-1RAs also significantly improved weight management for type 2 diabetes, with CagriSema performing the best for weight loss. The results prompt safety concerns for GLP-1RAs, especially with high dose administration, regarding gastrointestinal adverse events.
Study context
- Population
- Adults with T2D in RCTs of GLP-1 RA treatment vs placebo or any GLP-1 RA, follow-up ≥12 weeks
- Participants
- 39,246 adults76 RCTs15 GLP-1 RAs
- Comparison
- GLP-1 RA drugs vs placebo
- Outcome
- Glycaemic control: HbA1c and FPG
Pooled result
As reported in the abstract
Tirzepatide vs PlaceboMD, % HbA1c (95% CI)
Largest HbA1c reduction; SUCRA 94.2%; high confidence of evidence
−2.10(−2.47% to −1.74%)
Tirzepatide vs PlaceboMD, mmol/L FPG (95% CI)
SUCRA 97.2%; high confidence
−3.12(−3.59 to −2.66)
Further pooled results
| Outcome | MD (kg) (95% CI) | |
|---|---|---|
| Body weightCagriSemavs PlaceboHighest weight loss; high confidence of evidence | −14.03 (−17.05 to −11.00) | |
| Body weightTirzepatidevs PlaceboHigh confidence | −8.47 (−9.68 to −7.26) | |
| −20−10010Difference, kg (linear scale) |
| Outcome | Estimate |
|---|---|
| LDL-C and total cholesterolSemaglutide vs Placebo | −0.16 mmol/L LDL-C (CI −0.30 to −0.02) |
| LDL-C and total cholesterolSemaglutide vs Placebo | −0.48 mmol/L total cholesterol (CI −0.84 to −0.11) |
Safety
Gastrointestinal adverse events
- Awareness of GI adverse events induced by GLP-1 RAs; safety concerns especially for high dose administration
Original publication
Comparative effectiveness of GLP-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes: systematic review and network meta-analysis. BMJ. Published 29 January 2024. doi:10.
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