Clinical Efficacy of Once-weekly Glucagonlike Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes.

Jun 19, 2018The Journal of family practice

Effectiveness of Weekly Glucagon-like Peptide-1 Medicines for People with Type 2 Diabetes

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Abstract

Semaglutide led to a significant reduction in glycated hemoglobin by 0.62% compared to exenatide extended-release.

Once-weekly GLP-1 receptor agonists showed higher reductions in glycated hemoglobin, fasting plasma glucose, and body weight compared to placebo.
Semaglutide significantly lowered fasting plasma glucose by an estimated treatment difference of -15 mmol/L compared to exenatide extended-release.
Body weight decreased by an estimated treatment difference of -3.73 kg with semaglutide compared to exenatide extended-release.
Once-daily liraglutide demonstrated a significant reduction in body weight compared to albiglutide, dulaglutide, and exenatide extended-release.
Once-weekly GLP-1 receptor agonists provided better glycemic control than the diabetes medication sitagliptin.

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Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are indicated for restoring normoglycemia in patients with type 2 diabetes (T2D). This review analyzed and compared the efficacy results from 30 trials with the once-weekly (OW) GLP-1 RAs albiglutide, dulaglutide, exenatide extended-release (ER) and semaglutide. The 4 OW GLP-1 RAs showed a higher reduction in glycated hemoglobin (HbA1c), fasting plasma glucose (FPG) and body weight, when compared to placebo. Semaglutide significantly reduced the HbA1c level (estimated treatment difference [ETD]: -0.62%; 95% confidence interval [CI], -0.79 to -0.44; P<0.0001), FPG (ETD: -15 mmol/L; 95% CI, -22 to -8.3; P<0.0001) and body weight (ETD: -3.73 kg; 95% CI, -4.53 to -2.93; P<0.0001) compared with exenatide ER. A direct comparison between OW, once-daily (OD), and twice-daily (BD) GLP-1 RAs indicated some trends in efficacy, for example, with OD liraglutide, providing a significant reduction in body weight vs albiglutide (ETD: 1.55 kg; 95% CI, 1.05-2.06; P<0.0001 for albiglutide), dulaglutide (ETD: 0.71 kg; 95% CI, 0.17 -1.26; P=0.011 for dulaglutide), and exenatide ER (ETD: 0.90 kg; 95% CI, 0.39- 1.40; P=0.0005 for exenatide ER). OW GLP-1 RAs also offered improved glycemic control when compared with the dipeptidyl peptidase-4 inhibitor sitagliptin. In conclusion, OW GLP-1 RAs offer a valid therapeutic option for T2D.

Clinical Efficacy of Once-weekly Glucagonlike Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes.

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