Effect of semaglutide versus other glucagon-like peptide-1 receptor agonists on cardio-metabolic risk factors in patients with type 2 diabetes: A systematic review and meta-analysis of head-to-head, phase 3, randomized controlled trials

• Published in: Journal of diabetes and its complications Vol. 37; no. 8; p. 108529
• Main Authors: Patoulias, Dimitrios, Popovic, Djordje S., Stoian, Anca Pantea, Janez, Andrej, Sahebkar, Amirhossein, Rizzo, Manfredi
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2023; Elsevier Limited
• Subjects: Antidiabetics; Atherosclerosis; Bias; Blood pressure; Cholesterol; Clinical trials; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; GLP-1 receptor agonists; Glucagon; Glucagon-like peptide-1 receptor agonist; Glucagon-Like Peptide-1 Receptor Agonists; Glycated Hemoglobin; Glycemia; Humans; Hypoglycemic Agents - adverse effects; Meta-analysis; Metabolism; Peptides; Randomized Controlled Trials as Topic; Risk factor; Risk Factors; Semaglutide; Systematic review; Type 2 diabetes; Type 2 diabetes; Semaglutide; Glucagon-like peptide-1 receptor agonist; Glycemia; Risk factor
• ISSN: 1056-8727; 1873-460X; 1873-460X
• DOI: 10.1016/j.jdiacomp.2023.108529

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as a cornerstone treatment for type 2 diabetes mellitus (T2DM). The aim of the present meta-analysis was to assess whether semaglutide exerts greater effects on glycemia and other cardio-metabolic risk factors compared to other GLP-1RAs. PubMed and Cochrane Library databases, along with grey literature sources, were searched form inception to 8th February 2023, in order to retrieve head-to-head, phase 3 randomized controlled trials (RCTs) assessing the effect of semaglutide versus other GLP-1RAs on glycemia and other cardio-metabolic risk factors in T2DM. We finally pooled data from 5 RCTs in a total of 3760 randomized participants. Semaglutide compared to other GLP-1RAs provided a significantly greater reduction in HbA1c levels by 0.44 %, in fasting plasma glucose by 0.48 mmol/L, in body weight by 2.53 kg and in body mass index by 0.91 kg/m2. Subjects receiving semaglutide experienced significantly greater odds for achieving target and optimal HbA1c, along with significantly greater odds for weight loss >5 % and 10 %. However, subjects randomized to semaglutide also experienced significantly greater odds for gastrointestinal adverse events and treatment discontinuation. Semaglutide is more effective than rest GLP-1RAs, in terms of improvement in glycemia and other cardio-metabolic risk factors, among individuals with T2DM. •Glucagon-like peptide-1 receptor agonists (GLP-1RAs) constitute a cornerstone treatment option in type 2 diabetes mellitus (T2DM).•Semaglutide confers greater improvement in glycemia, body weight loss, waist circumference and blood pressure, compared to other GLP-1RAs.•Subjects administered semaglutide have significantly greater odds for treatment discontinuation due to gastrointestinal adverse events.