Efficacy and safety of GLP-1 receptor agonists versus SGLT-2 inhibitors in overweight/obese patients with or without diabetes mellitus: a systematic review and network meta-analysis

Mar 7, 2023BMJ open

Effectiveness and safety of GLP-1 drugs compared to SGLT-2 drugs in overweight or obese patients with and without diabetes

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Abstract

Sixty-one randomized controlled trials were included in the analysis of and .

  • Both GLP-1 receptor agonists and SGLT-2 inhibitors resulted in at least 5% body weight loss and reductions in HbA1c and fasting plasma glucose compared to placebo.
  • GLP-1 receptor agonists were found to be superior to SGLT-2 inhibitors for HbA1c reduction with a mean difference of -0.39%.
  • Semaglutide 2.4 mg was noted as one of the most effective treatments, achieving a mean weight loss of -11.51 kg and significant decreases in HbA1c and fasting plasma glucose.
  • Systolic and diastolic blood pressure reductions were also observed with semaglutide, with mean differences of -4.89 mm Hg and -1.59 mm Hg, respectively.
  • GLP-1 receptor agonists were associated with a higher risk of adverse events compared to SGLT-2 inhibitors, which were deemed relatively safe.

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Key numbers

-11.51 kg
Body Weight Reduction (Semaglutide 2.4 mg)
Mean difference compared to placebo.
-0.39%
HbA1c Reduction (GLP-1RAs vs. SGLT-2is)
Mean difference in HbA1c levels.
OR 1.42
Serious Adverse Events (Semaglutide 2.4 mg)
Odds ratio for serious adverse events.

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