Efficacy and safety of glucagon-like peptide-1 receptor agonists in the elderly versus non-elderly patients with type 2 diabetes mellitus: insights from a systematic review

• Published in: Endocrine Journal Vol. 71; no. 6; pp. 571 - 582
• Main Authors: Wang, Yao, Wang, Jiangling, Gong, Qian, Wu, Haoming, Yang, Shuhao, He, Jufeng, Hu, Xulin, Huang, Tianfang
• Format: Journal Article
• Language: English
• Published: Japan The Japan Endocrine Society 01.01.2024; Japan Science and Technology Agency
• Subjects: Age Factors; Aged; Agonists; Blood Glucose - analysis; Blood Glucose - drug effects; Blood Glucose - metabolism; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Diarrhea; Efficacy; Elderly; Glucagon; Glucagon-like peptide 1; Glucagon-Like Peptide-1 Receptor - agonists; Glucagon-like peptide-1 receptor agonists (GLP-1RAs); Humans; Hypoglycemia; Hypoglycemia - chemically induced; Hypoglycemia - epidemiology; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Middle Aged; Peptides; Safety; Systematic review; Treatment Outcome; Type 2 diabetes; Weight Loss - drug effects; Type 2 diabetes; Efficacy; Safety; Glucagon-like peptide-1 receptor agonists (GLP-1RAs); Elderly
• ISSN: 0918-8959; 1348-4540; 1348-4540
• DOI: 10.1507/endocrj.EJ23-0384

This systematic review aimed to compare the influence of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on the efficacy and safety of elderly patients with type 2 diabetes and younger individuals. A comprehensive search of PubMed, Embase, and Web of Science databases was conducted up to September 2022. The summary standard means difference and odds ratios were calculated. Thirteen articles were included in the analysis. The incidence of adverse events (AEs) leading to discontinuation was higher in elderly patients (OR = 0.67, 95% CI 0.47 to 0.96, p = 0.028). However, no significant differences were observed in weight loss (SMD = 0.03, 95% CI –0.12 to 0.19, p = 0.686), HbA1c% (SMD = –0.02, 95% CI –0.11 to 0.08, p = 0.715), FBG levels (SMD = –0.03, 95% CI –0.11 to 0.06, p = 0.537), and the incidence of overall AEs (OR = 0.85, 95% CI 0.71 to 1.01, p = 0.072), serious AEs (OR = 0.68, 95% CI 0.45 to 1.04, p = 0.077), nausea (OR = 0.91, 95% CI 0.81 to 1.03, p = 0.140), vomiting (OR = 0.95, 95% CI 0.79 to 1.13, p = 0.532), diarrhea (OR = 0.86, 95% CI 0.72 to 1.02, p = 0.081), and hypoglycemia (OR = 1.22, 95% CI 0.90 to 1.65, p = 0.193). In conclusion, while certain AEs leading to discontinuation may be more prevalent in older patients, GLP-1RAs are effective for weight loss and lead to decreased glucose concentrations with a low rate of complications in elderly patients.