Efficacy and safety of GLP-1 agonists in the treatment of T2DM: A systematic review and network meta-analysis
Abstract To compare efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in subjects with type 2 diabetes (T2DM). Electronic databases were searched from inception to 2nd October 2024 for randomised controlled trials comparing GLP-1RAs treating T2DM. Bayesian network meta-anal...
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Nature Portfolio
2025-07-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-025-09807-0 |
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| author | Xiaoyu Ren Honghao Hua Yuanqin Wu Wei Zhang Xianzhen Long Yana Bai Ning Cheng |
| author_facet | Xiaoyu Ren Honghao Hua Yuanqin Wu Wei Zhang Xianzhen Long Yana Bai Ning Cheng |
| author_sort | Xiaoyu Ren |
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| description | Abstract To compare efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in subjects with type 2 diabetes (T2DM). Electronic databases were searched from inception to 2nd October 2024 for randomised controlled trials comparing GLP-1RAs treating T2DM. Bayesian network meta-analyses were conducted to analyze metabolic and safety outcomes. 64 trials comprising of 25,572 participants were identified. Compared to placebo, tirzepatide showed the greatest reduction in HbA1-c (MD: -2.3%) and FPG (MD: -3.1mmol/L); semaglutide was second (HbA1-c: MD: -1.5%; FPG: MD: -2mmol/L); liraglutide was third (HbA1-c: MD: -1.2% FPG: MD: -1.6mmol/L) (P<0.05). All treatments showed no statistically significant differences in BMI, SBP, DBP, TC, HDL-C and LDL-C compared to placebo. Tirzepatide (MD: -9.1 kg), semaglutide (MD: -2.8 kg) and liraglutide (MD: -1.2 kg) (P<0.05) had significant reduction in body weight compared to placebo. GLP-1 RAs had higher risk of gastrointestinal symptoms. Semaglutide increased the risk of hypoglycemia compared to placebo while liraglutide reduced the risk of hypoglycemia compared to traditional antidiabetic drugs. GLP-1RAs improve glycaemic control, with tirzepatide, semaglutide and liraglutide exhibiting the most significant improvements. Tirzepatide is more suitable for treating T2DM with obesity. For individuals with normal weight, both semaglutide and liraglutide are generally more effective for treating T2DM. However, considering the potential for semaglutide to cause hypoglycemia, liraglutide may be the optimal choice for T2DM treatment to minimize the risk of hypoglycemia. |
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| id | doaj-art-b2d4b5150e2c4269956327a0b4abf2d9 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-b2d4b5150e2c4269956327a0b4abf2d92025-08-20T03:38:15ZengNature PortfolioScientific Reports2045-23222025-07-0115111510.1038/s41598-025-09807-0Efficacy and safety of GLP-1 agonists in the treatment of T2DM: A systematic review and network meta-analysisXiaoyu Ren0Honghao Hua1Yuanqin Wu2Wei Zhang3Xianzhen Long4Yana Bai5Ning Cheng6Key Laboratory of Preclinical Study for New Drugs of Gansu Province, Basic Medical College, Lanzhou UniversityInstitute of Epidemiology and Statistics, School of Public Health, Lanzhou UniversityInstitute of Epidemiology and Statistics, School of Public Health, Lanzhou UniversityKey Laboratory of Preclinical Study for New Drugs of Gansu Province, Basic Medical College, Lanzhou UniversityInstitute of Epidemiology and Statistics, School of Public Health, Lanzhou UniversityInstitute of Epidemiology and Statistics, School of Public Health, Lanzhou UniversityKey Laboratory of Preclinical Study for New Drugs of Gansu Province, Basic Medical College, Lanzhou UniversityAbstract To compare efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in subjects with type 2 diabetes (T2DM). Electronic databases were searched from inception to 2nd October 2024 for randomised controlled trials comparing GLP-1RAs treating T2DM. Bayesian network meta-analyses were conducted to analyze metabolic and safety outcomes. 64 trials comprising of 25,572 participants were identified. Compared to placebo, tirzepatide showed the greatest reduction in HbA1-c (MD: -2.3%) and FPG (MD: -3.1mmol/L); semaglutide was second (HbA1-c: MD: -1.5%; FPG: MD: -2mmol/L); liraglutide was third (HbA1-c: MD: -1.2% FPG: MD: -1.6mmol/L) (P<0.05). All treatments showed no statistically significant differences in BMI, SBP, DBP, TC, HDL-C and LDL-C compared to placebo. Tirzepatide (MD: -9.1 kg), semaglutide (MD: -2.8 kg) and liraglutide (MD: -1.2 kg) (P<0.05) had significant reduction in body weight compared to placebo. GLP-1 RAs had higher risk of gastrointestinal symptoms. Semaglutide increased the risk of hypoglycemia compared to placebo while liraglutide reduced the risk of hypoglycemia compared to traditional antidiabetic drugs. GLP-1RAs improve glycaemic control, with tirzepatide, semaglutide and liraglutide exhibiting the most significant improvements. Tirzepatide is more suitable for treating T2DM with obesity. For individuals with normal weight, both semaglutide and liraglutide are generally more effective for treating T2DM. However, considering the potential for semaglutide to cause hypoglycemia, liraglutide may be the optimal choice for T2DM treatment to minimize the risk of hypoglycemia.https://doi.org/10.1038/s41598-025-09807-0Network meta-analysisGlucagon-like peptide-1 receptor agonistsType 2 diabetes mellitus |
| spellingShingle | Xiaoyu Ren Honghao Hua Yuanqin Wu Wei Zhang Xianzhen Long Yana Bai Ning Cheng Efficacy and safety of GLP-1 agonists in the treatment of T2DM: A systematic review and network meta-analysis Scientific Reports Network meta-analysis Glucagon-like peptide-1 receptor agonists Type 2 diabetes mellitus |
| title | Efficacy and safety of GLP-1 agonists in the treatment of T2DM: A systematic review and network meta-analysis |
| title_full | Efficacy and safety of GLP-1 agonists in the treatment of T2DM: A systematic review and network meta-analysis |
| title_fullStr | Efficacy and safety of GLP-1 agonists in the treatment of T2DM: A systematic review and network meta-analysis |
| title_full_unstemmed | Efficacy and safety of GLP-1 agonists in the treatment of T2DM: A systematic review and network meta-analysis |
| title_short | Efficacy and safety of GLP-1 agonists in the treatment of T2DM: A systematic review and network meta-analysis |
| title_sort | efficacy and safety of glp 1 agonists in the treatment of t2dm a systematic review and network meta analysis |
| topic | Network meta-analysis Glucagon-like peptide-1 receptor agonists Type 2 diabetes mellitus |
| url | https://doi.org/10.1038/s41598-025-09807-0 |
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