Comparative Effectiveness of Glucagon-like Peptide-1- Receptor Agonists in Patients With Heart Failure With Preserved or Minimally Reduced Ejection Fraction: A Comprehensive Bayesian Network Meta-Analysis and Network Meta-Regression
Authors' conclusion
GLP-1 RAs provide significant benefits for patients with HFpEF or HFmrEF, with semaglutide offering more advantages than tirzepatide and exenatide.
Study context
- Population
- Patients with heart failure (HF) with preserved or minimally reduced ejection fraction (HFpEF or HFmrEF)8 reports
- Participants
- 24,099 patients6 phase 3 RCTs
- Comparison
- GLP-1 RAs vs placebo
- Outcome
- Hospitalization for HF (HHF)
Methodological detailsSUCRA ranking, Trials mostly at low risk of bias
- SUCRA ranking
- Trials mostly at low risk of bias
Pooled result
As reported in the abstract
HHF
Each group vs placeboHazard ratio (95% CrI)
Semaglutide95% CrI
0.52(0.25–0.87)
Tirzepatide95% CrI; no effect
0.51(0.16–1.24)
Exenatide95% CrI; no effect
0.82(0.33–1.73)
Further pooled results
All-cause mortality
- Semaglutide and exenatide, but not tirzepatide, reduced risk; exenatide ranked highest
CV mortality
- None affected CV mortality; semaglutide ranked highest
Worsening HF events
- Semaglutide decreased risk; tirzepatide did not; semaglutide ranked highest
Body weight
- Tirzepatide and semaglutide enabled weight loss; tirzepatide ranked highest
6-minute walk distance
- Only semaglutide notably enhanced 6-minute walk distance; ranked highest
Original publication
Comparative Effectiveness of Glucagon-like Peptide-1- Receptor Agonists in Patients With Heart Failure With Preserved or Minimally Reduced Ejection Fraction: A Comprehensive Bayesian Network Meta-Analysis and Network Meta-Regression. Endocr Pract. Published 18 June 2025. doi:10.
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