Dose-Response Relationship of Glucagon-like Peptide-1 Receptor Agonists on HbA1c and Body Weight in Type 2 Diabetes Mellitus: A Systematic Review and Network Meta-Analysis

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice Pub Date : 2025-02-01 DOI:10.1016/j.eprac.2024.11.013

Qian-Qin Chen MD , Yong Yang PhD , Jian-Ya Xu MD , Junyu Wang PhD , Tuan-Yu Fang MD , Yuan Yuan MD , Chengji Wang PhD , Li Zhang PhD

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引用次数: 0

Abstract

Objective

To explore the dose-response relationship of GLP-1 RAs in reducing glycated hemoglobin (HbA1c), body weight, and incidence of adverse events among type 2 diabetes mellitus (T2DM) patients.

Methods

This systematic review and network meta-analysis followed the PRISMA guidelines. We conducted a systematic search of PubMed, Medline, Embase, Cochrane Central Register of Controlled Trials, and Web of Science for articles published up to October 20, 2024. Selected studies were randomized controlled trials focusing on adult T2DM patients treated with GLP-1 RAs. Primary outcomes included changes in HbA1c, body weight, and incidence of adverse events. Data extraction was performed by 2 independent researchers. Model-Based Network Meta-Analysis employing a random-effects Bayesian approach was used to synthesize the data.

Results

The analysis included 62 trials with 17 140 participants. The study revealed a nonlinear dose-response relationship for various GLP-1 RAs, indicating significant reductions in HbA1c and body weight. Tirzepatide (10 mg/wk) was found to be particularly effective, reducing HbA1c by −1.76% (95% credible intervals: −2.10 to −1.41) and body weight by −8.63 kg (95% credible intervals: −9.84 to −7.39) without a significant increase in adverse events, highlighting its optimal balance between efficacy and safety. Other GLP-1 RAs also showed significant efficacy, underscoring the overall benefits of this class of medications in managing T2DM.

Conclusion

Our findings indicate a nonlinear dose-response relationship for GLP-1 RAs in managing T2DM. Tirzepatide at a dose of 10 mg/wk is identified as an optimal clinical dose offering a balance between efficacy and safety, contributing to refining T2DM management strategies and potentially enhancing patient outcomes.

查看原文本刊更多论文

GLP-1受体激动剂对2型糖尿病患者HbA1c和体重的剂量-反应关系：一项系统综述和网络meta分析

目的：探讨GLP-1 RAs在降低T2DM患者HbA1c、体重及不良事件发生率中的量效关系。方法：本系统综述和网络荟萃分析遵循PRISMA指南。我们对PubMed、Medline、Embase、Cochrane Central Register of Controlled Trials和Web of Science进行了系统检索，检索截止到2024年10月20日发表的文章。所选研究为随机对照试验（rct），重点关注GLP-1 RAs治疗的成年T2DM患者。主要结局包括HbA1c、体重和不良事件发生率的变化。数据提取由两名独立研究人员完成。采用随机效应贝叶斯方法的基于模型的网络元分析（MBNMA）对数据进行综合。结果：分析包括62项试验，17140名参与者。该研究揭示了各种GLP-1 RAs的非线性剂量-反应关系，表明HbA1c和体重显著降低。替西帕肽（10mg /周）被发现特别有效，使HbA1c降低-1.76% (95% CrI: -2.10至-1.41)，体重降低-8.63 kg (95% CrI: -9.84至-7.39)，而不良事件没有显著增加，突出了其在疗效和安全性之间的最佳平衡。其他GLP-1 RAs也显示出显著的疗效，强调了这类药物在治疗T2DM方面的总体益处。结论：我们的研究结果表明GLP-1 RAs在治疗T2DM方面存在非线性剂量-反应关系。替西帕肽10mg /周的剂量被认为是最佳的临床剂量，可以在疗效和安全性之间取得平衡，有助于完善T2DM管理策略，并有可能提高患者的预后。

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

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.