Semaglutide for the treatment of type 2 Diabetes Mellitus: A systematic review and network meta-analysis of safety and efficacy outcomes

• Published in: Diabetes & metabolic syndrome clinical research & reviews Vol. 16; no. 6; p. 102511
• Main Authors: Zaazouee, Mohamed Sayed, Hamdallah, Aboalmagd, Helmy, Sara Kamel, Hasabo, Elfatih A., Sayed, Ahmed Kamal, Gbreel, Mohamed Ibrahim, Elmegeed, Aya Abd, Aladwan, Hala, Elshanbary, Alaa Ahmed, Abdel-Aziz, Walid, Elshahawy, Israa Mohamed, Rabie, Shehab, Elkady, Sherouk, Ali, Ahmed Said, Ragab, Khaled Mohamed, Nourelden, Anas Zakarya
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.06.2022
• Subjects: Glucagon-like peptide-1 receptor agonist; Hyperglycaemia; Network meta-analysis; Semaglutide; Type 2 diabetes mellitus; Semaglutide; Network meta-analysis; Hyperglycaemia; Type 2 diabetes mellitus; Glucagon-like peptide-1 receptor agonist
• ISSN: 1871-4021; 1878-0334
• DOI: 10.1016/j.dsx.2022.102511

To assess the safety and efficacy of semaglutide compared with placebo and other anti-hyperglycaemic agents in type 2 diabetes (T2DM). We searched PubMed, Scopus, Web of Science, and Cochrane library for relevant randomized controlled trials (RCTs). A network meta-analysis was conducted to compare different doses, durations, and interventions in T2DM. We presented results as mean difference (MD) or relative risk (RR) and 95% confidence interval (CI). Twenty-six included RCTs studied different doses of subcutaneous (SC) and oral semaglutide, tirzepatide, liraglutide, sitagliptin, canagliflozin, and empagliflozin compared with placebo. Tirzepatide showed the highest efficacy, however, it was comparable to semaglutide. SC semaglutide 1 mg once-weekly showed higher reduction in HbA1c (MD = −1.72, 95% CI [-2.32; −1.12]), and fasting blood glucose (MD = −1.93, 95% CI [-2.81; −1.04]) versus placebo at 30 weeks and other timepoints. Adverse events (ADs) were comparable to placebo with oral and SC semaglutide, oral sitagliptin, SC liraglutide, and oral empagliflozin at most timepoints. However, SC semaglutide 0.8 mg and tirzepatide 10 mg groups had the highest gastrointestinal adverse events. Tirzepatide, oral and SC semaglutide has a favourable efficacy in treating T2DM. The adverse events were comparable to placebo; however, gastrointestinal adverse events were highly recorded in tirzepatide, oral and SC semaglutide groups. •Our study showed that semaglutide at 1 mg subcutaneous weekly dose and 14 mg oral daily dose were the favourable doses.•Semaglutide showed more reduction of HbA1c, fasting blood glucose, and bodyweight than other anti-diabetic medications.•Semaglutide showed less hypoglycaemia and other adverse events compared to other anti-diabetic medications.•Semaglutide has a high probability of being the optimal therapy for type 2 diabetes.