Faculty of Medicine, Al-Azhar University, Assiut, Egypt; International Medical Research Association (IMedRA), Egypt.
Faculty of Medicine Al-Azhar University, Damietta, Egypt; International Medical Research Association (IMedRA), Egypt.
Diabetes Metab Syndr. 2022 Jun;16(6):102511. doi: 10.1016/j.dsx.2022.102511. Epub 2022 May 20.
To assess the safety and efficacy of semaglutide compared with placebo and other anti-hyperglycaemic agents in type 2 diabetes (T2DM).
We searched PubMed, Scopus, Web of Science, and Cochrane library for relevant randomized controlled trials (RCTs). A network meta-analysis was conducted to compare different doses, durations, and interventions in T2DM. We presented results as mean difference (MD) or relative risk (RR) and 95% confidence interval (CI).
Twenty-six included RCTs studied different doses of subcutaneous (SC) and oral semaglutide, tirzepatide, liraglutide, sitagliptin, canagliflozin, and empagliflozin compared with placebo. Tirzepatide showed the highest efficacy, however, it was comparable to semaglutide. SC semaglutide 1 mg once-weekly showed higher reduction in HbA (MD = -1.72, 95% CI [-2.32; -1.12]), and fasting blood glucose (MD = -1.93, 95% CI [-2.81; -1.04]) versus placebo at 30 weeks and other timepoints. Adverse events (ADs) were comparable to placebo with oral and SC semaglutide, oral sitagliptin, SC liraglutide, and oral empagliflozin at most timepoints. However, SC semaglutide 0.8 mg and tirzepatide 10 mg groups had the highest gastrointestinal adverse events.
Tirzepatide, oral and SC semaglutide has a favourable efficacy in treating T2DM. The adverse events were comparable to placebo; however, gastrointestinal adverse events were highly recorded in tirzepatide, oral and SC semaglutide groups.
评估司美格鲁肽与安慰剂和其他抗高血糖药物在 2 型糖尿病（T2DM）中的安全性和疗效。
我们检索了 PubMed、Scopus、Web of Science 和 Cochrane 图书馆中相关的随机对照试验（RCT）。对不同剂量、持续时间和干预措施在 T2DM 中的疗效进行了网络荟萃分析。我们以均数差值（MD）或相对风险（RR）和 95%置信区间（CI）表示结果。
26 项纳入的 RCT 研究了不同剂量的皮下（SC）和口服司美格鲁肽、替西帕肽、利拉鲁肽、西格列汀、卡格列净和恩格列净与安慰剂的比较。替西帕肽显示出最高的疗效，但与司美格鲁肽相当。SC 司美格鲁肽 1mg 每周一次在 30 周和其他时间点显示出更高的糖化血红蛋白（HbA）降幅（MD=-1.72，95%CI[-2.32；-1.12]）和空腹血糖（MD=-1.93，95%CI[-2.81；-1.04]）。口服和 SC 司美格鲁肽、口服西格列汀、SC 利拉鲁肽和口服恩格列净在大多数时间点的不良反应（ADs）与安慰剂相当。然而，SC 司美格鲁肽 0.8mg 和替西帕肽 10mg 组的胃肠道不良反应发生率最高。
替西帕肽、口服和 SC 司美格鲁肽在治疗 T2DM 方面具有良好的疗效。不良反应与安慰剂相当；然而，替西帕肽、口服和 SC 司美格鲁肽组胃肠道不良反应发生率较高。
