Comparing once-weekly semaglutide to incretin-based therapies in patients with type 2 diabetes: a systematic review and meta-analysis - 20/03/19
Abstract |
Aims |
Our aim was to compare once-weekly semaglutide to incretin-based therapies – defined as either dipeptidyl peptidase-4 inhibitors (DPP-4i) or other glucagon-like peptide-1 receptor agonist (GLP-1RA) – in patients with type 2 diabetes.
Methods |
We searched for randomized trials comparing once-weekly semaglutide to other incretin-based therapies in patients with type 2 diabetes. We pooled trials that compared semaglutide to other GLP-1RA together, and those comparing semaglutide to DPP-4i together. The primary outcome was the change in haemoglobin A1c over time.
Results |
Five trials met our inclusion criteria. There was a significantly greater reduction in haemoglobin A1c favouring semaglutide when compared to other GLP-1RA or DPP-4i [MD (95% CI) = −0.38% (−0.62, −0.15) and −1.14% (−1.53, −0.75) respectively]. There was a significantly greater weight loss favouring semaglutide when compared to other GLP-1RA or DPP-4i [MD (95% CI) = −2.50 kg (−3.91, −1.09) and −3.19 kg (−3.66, −2.72) respectively]. The proportion of patients achieving glycaemic goals and goal weight loss was greater in semaglutide-treated patients when compared to either other GLP-1RA or DPP-4i. However, semaglutide-treated patients had a significantly higher incidence of gastrointestinal side effects.
Conclusions |
While both once-weekly semaglutide and other incretin-based therapies can reduce haemoglobin A1c, semaglutide causes a more potent haemoglobin A1c reduction and greater weight loss when compared to other incretin-based therapies. However, this potent effect of semaglutide was associated with a higher incidence of gastrointestinal side effects. Additional studies are needed to determine whether this marked reduction in both haemoglobin A1c and body weight may translate into improved cardiovascular outcomes.
Le texte complet de cet article est disponible en PDF.Abbreviations : DPP-4i, GLP-1RA, ADA, MD, CI, RR, FDA, NCT, SD
Keywords : Dipeptidyl peptidase-4 inhibitors, Glucagon-like peptide-1 receptor agonist, Meta-analysis, Semaglutide, Type 2 diabetes
Plan
Vol 45 - N° 2
P. 102-109 - avril 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.