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比较不同剂量替尔泊肽治疗2型糖尿病的疗效和安全性:一项随机对照试验的荟萃分析

Comparing Efficacy and Safety of Different Doses of Tirzepatide for the Treatment of Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials.

作者信息

Khan Zarghuna, Naeem Muhammad O, Khan Saad Khalid, Khan Faisal, Abdullah Muhammad, Attique Ilqa, Dur Muhammad Sana, Amin Adil

机构信息

Internal Medicine, Rehman Medical Institute, Peshawar, PAK.

Pathology, Rehman Medical Institute, Peshawar, PAK.

出版信息

Cureus. 2023 Aug 29;15(8):e44314. doi: 10.7759/cureus.44314. eCollection 2023 Aug.

Abstract

Our study assessed the efficacy and safety of the three primary tirzepatide (TZP) doses, 5 mg, 10 mg, and 15 mg using network meta-analysis to assess their relative impact on type 2 diabetes mellitus (T2DM) treatment. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Two authors independently screened online databases, including PubMed, Cochrane Library, and Embase. We employed the keywords "Type 2 diabetes OR T2DM or diabetes" AND "Tirzepatide OR LY3298176 OR twincretin OR dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist" AND "randomized controlled trial". The outcomes evaluated in this study comprised changes in hemoglobin (Hb)A1c levels from baseline (%), changes in weight from baseline (Kg), changes in fasting serum glucose from baseline (mg/dL), and occurrences of serious adverse events (SAE), adverse events (AE) and major adverse cardiovascular events (MACE). A total of eight studies met the inclusion criteria and were included in this meta-analysis. Our findings suggest that among the evaluated doses, TZP at 15 mg demonstrated superior effectiveness in reducing HbA1c, weight, and fasting serum glucose compared to doses of 10 mg and 5 mg. Notably, the reduction in HbA1c and weight showed a dose-dependent trend, with the 15 mg dose achieving the most substantial benefits. The safety analysis indicated that while serious adverse events and major adverse cardiovascular events (MACE) did not significantly differ among the three doses, the risk of overall adverse events was notably higher in the 10 mg and 15 mg TZP groups compared to the 5 mg group.

摘要

我们的研究使用网络荟萃分析评估了三种主要剂量(5毫克、10毫克和15毫克)替尔泊肽(TZP)的疗效和安全性,以评估它们对2型糖尿病(T2DM)治疗的相对影响。本研究遵循系统评价和荟萃分析的首选报告项目(PRISMA)2020指南。两位作者独立筛选了在线数据库,包括PubMed、Cochrane图书馆和Embase。我们使用了关键词“2型糖尿病或T2DM或糖尿病”以及“替尔泊肽或LY3298176或双效肠促胰岛素或双重葡萄糖依赖性促胰岛素多肽和胰高血糖素样肽-1受体激动剂”以及“随机对照试验”。本研究评估的结果包括糖化血红蛋白(Hb)A1c水平相对于基线的变化(%)、体重相对于基线的变化(千克)、空腹血清葡萄糖相对于基线的变化(毫克/分升),以及严重不良事件(SAE)、不良事件(AE)和主要不良心血管事件(MACE)的发生情况。共有八项研究符合纳入标准并被纳入本荟萃分析。我们的研究结果表明,在评估的剂量中,15毫克的TZP在降低HbA1c、体重和空腹血清葡萄糖方面比10毫克和5毫克的剂量表现出更优的效果。值得注意的是,HbA1c和体重的降低呈现出剂量依赖性趋势,15毫克剂量带来的益处最为显著。安全性分析表明,虽然三种剂量的严重不良事件和主要不良心血管事件(MACE)没有显著差异,但与5毫克组相比

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d81/10536403/5ef88b1ff0d1/cureus-0015-00000044314-i01.jpg

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