Tirzepatide outcompetes long-acting insulin in managing type 2 diabetes: a meta-analysis of three phase 3 randomized controlled trials.

IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Moein Ala, Razieh Mohammad Jafari, Ahmad Reza Dehpour, Mohammad Poursalehian
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引用次数: 0

Abstract

In this systematic review and meta-analysis, we compared the efficacy and safety of tirzepatide with those of long-acting or ultra-long-acting insulin for type 2 diabetes. PubMed, Web of Science, Scopus, and Google Scholar were searched from the inception to August 20, 2023. All clinical trials or randomized clinical trials comparing the efficacy of tirzepatide with long-acting or ultra-long-acting insulin for treating type 2 diabetes were included. Three randomized clinical trials, namely SURPASS-3, SURPASS-4, and SURPASS-AP-Combo, with 4339 patients were included. Compared with daily insulin glargine and degludec, once-weekly tirzepatide significantly decreased HbA1c (WMD -1.08%, 95% CI (-1.37, -0.78)), 2h-posprandial blood sugar (BS) (WMD -28.19 mg/dL, 95% CI (-44.98, -11.41)), pre-meal BS (WMD -11.86 mg/dL, 95% CI (-22.83, -0.9)), body weight (WMD -10.61 kg, 95% CI (-13.24, -7.97)), systolic blood pressure (WMD -6.47 mmHg, 95% CI (-8.32, -4.61)), diastolic blood pressure (WMD -2.30 mmHg, 95% CI (-3.05, -1.55)), total cholesterol (WMD -4.78%, 95% CI (-7.05, -2.50)), triglyceride (WMD -14.49%, 95% CI (-19.55, -9.43)), LDL cholesterol (WMD -5.98%, 95% CI (-9.83, -2.13)), and VLDL cholesterol (WMD -14.18%, 95% CI (-19.03, -9.33)) and increased HDL cholesterol (WMD 7.13%, 95% CI (-9.83, -2.13)), with a lower risk of hypoglycemia defined as BS ≤ 70 mg/dL (RR 0.46, 95% CI (0.28, 0.75)). All doses of once-weekly tirzepatide (5 mg, 10 mg, and 15 mg) were superior or non-inferior to insulin. Once-weekly tirzepatide can be a substitution for long-acting insulin in type 2 diabetes with a greater efficacy.

Abstract Image

在控制 2 型糖尿病方面,替扎帕肽优于长效胰岛素:三项第三阶段随机对照试验的荟萃分析。
在这项系统综述和荟萃分析中,我们比较了替哌肽与长效或超长效胰岛素治疗 2 型糖尿病的疗效和安全性。我们检索了 PubMed、Web of Science、Scopus 和 Google Scholar 从开始到 2023 年 8 月 20 日的所有文献。纳入了所有比较替扎帕肽与长效或超长效胰岛素治疗 2 型糖尿病疗效的临床试验或随机临床试验。其中包括三项随机临床试验,即 SURPASS-3、SURPASS-4 和 SURPASS-AP-Combo,共有 4339 名患者参加。与每日使用格列奈胰岛素和德格列奈胰岛素相比,每周一次使用替扎帕肽可显著降低 HbA1c(WMD -1.08%,95% CI (-1.37, -0.78))、餐前 2 小时血糖(BS)(WMD -28.19 mg/dL,95% CI (-44.98, -11.41)、餐前 BS(WMD -11.86 mg/dL,95% CI(-22.83,-0.9))、体重(WMD -10.61 kg,95% CI(-13.24,-7.97))、收缩压(WMD -6.47 mmHg,95% CI(-8.32,-4.61))、舒张压(WMD -2.30毫米汞柱,95% CI(-3.05,-1.55))、总胆固醇(WMD -4.78%,95% CI(-7.05,-2.50))、甘油三酯(WMD -14.49%,95% CI(-19.55,-9.43))、低密度脂蛋白胆固醇(WMD -5.98%,95% CI(-9.83,-2.13))和超低密度脂蛋白胆固醇(WMD -14.18%,95% CI (-19.03,-9.33))和高密度脂蛋白胆固醇增加(WMD 7.13%,95% CI (-9.83,-2.13)),而 BS ≤ 70 mg/dL 的低血糖风险较低(RR 0.46,95% CI (0.28,0.75))。所有剂量的每周一次替扎帕肽(5 毫克、10 毫克和 15 毫克)均优于或不劣于胰岛素。在2型糖尿病患者中,一周一次的替扎帕肽可替代长效胰岛素,且疗效更好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International Journal of Obesity
International Journal of Obesity 医学-内分泌学与代谢
CiteScore
10.00
自引率
2.00%
发文量
221
审稿时长
3 months
期刊介绍: The International Journal of Obesity is a multi-disciplinary forum for research describing basic, clinical and applied studies in biochemistry, physiology, genetics and nutrition, molecular, metabolic, psychological and epidemiological aspects of obesity and related disorders. We publish a range of content types including original research articles, technical reports, reviews, correspondence and brief communications that elaborate on significant advances in the field and cover topical issues.
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