Once-Weekly Tirzepatide Versus Once-Daily Basal Insulin in Managing Type 2 Diabetes Inadequately Controlled With Oral anti-Hyperglycemic Drugs: A Systematic Review and Meta-Analysis

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice Pub Date : 2025-03-01 DOI:10.1016/j.eprac.2024.12.005

A.B.M. Kamrul-Hasan MBBS, MD , Shahjada Selim MBBS, MD, FACE , Faria Afsana MBBS, MD, FACE , Lakshmi Nagendra MBBS, MRCP, MD, DM, DrNB, FRCP , Rezwana Ahmed MS, PhD , Deep Dutta MBBS, MD, DM, DNB, FRCP, FACE

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引用次数: 0

Abstract

Objective

No meta-analysis has been published comparing the efficacy and safety of tirzepatide vs once-daily basal insulins in subjects with type 2 diabetes (T2D) inadequately controlled with oral anti-hyperglycemic drugs. This meta-analysis was conducted to address this knowledge gap.

Methods

Randomized controlled trials involving subjects with T2D inadequately controlled with oral anti-hyperglycemic drugs and receiving tirzepatide in intervention arm and basal insulins in control arm as add-on therapy were searched throughout the electronic databases. The primary outcome assessed was the change from baseline in hemoglobin A1c (HbA1c).

Results

Three randomized controlled trials involving 4339 subjects met the inclusion criteria. Compared to basal insulins, tirzepatide arms achieved greater reductions from the baseline in HbA1c (tirzepatide 5 mg: mean difference (MD) −0.89% [95% CI: −1.23, −0.54]; tirzepatide 10 mg: MD −1.11% [95% CI: −1.42, −0.79]; and tirzepatide 15 mg: MD −1.23% [95% CI: −1.48, −0.97]; P < .00001 for all). Additionally, the proportions of patients achieving HbA1c levels below 7.0%, 6.5%, and 5.7% were significantly greater in the tirzepatide groups than in the basal insulin group. Greater body weight and blood pressure reductions were observed with tirzepatide than with basal insulins. Moreover, tirzepatide had a more favorable impact on lipid profile. Hypoglycemia was less frequent with tirzepatide. Gastrointestinal adverse events (AEs) were more frequent with tirzepatide (all doses) than basal insulin, although serious AEs were comparable between the 2 groups.

Conclusion

Tirzepatide outperformed basal insulins in controlling blood glucose, body weight, blood pressure, and lipids in subjects with T2D and is generally well-tolerated except for its higher gastrointestinal AEs.

查看原文本刊更多论文

每周一次替扎帕肽与每日一次基础胰岛素治疗口服降糖药控制不佳的 2 型糖尿病：系统综述和荟萃分析。

研究目的对于口服降糖药物（OADs）控制不佳的 2 型糖尿病（T2D）患者，尚未发表过比较替扎帕肽与每日一次基础胰岛素疗效和安全性的荟萃分析。本荟萃分析旨在填补这一知识空白：在所有电子数据库中检索了涉及口服降糖药控制不佳的 T2D 患者的随机对照试验（RCT），这些患者在干预组接受替扎帕肽治疗，在对照组接受基础胰岛素作为附加疗法。评估的主要结果是 HbA1c 从基线开始的变化：有三项研究符合纳入标准，涉及 4,339 名受试者。与基础胰岛素相比，替扎帕肽治疗组的 HbA1c 从基线降低的幅度更大（替扎帕肽 5 毫克，MD -0.89% [95%] ）：MD -0.89% [95% CI: -1.23, -0.54]; tirzepatide 10 mg：MD -1.11% [95% CI: -1.42, -0.79]；替唑帕肽 15 mg：MD -1.23% [95% CI: -1.48, -0.97]；P 结论：在控制 T2D 患者的血糖、体重、血压和血脂方面，替扎帕肽优于基础胰岛素。

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.