Karimi Mohammad Amin, Gholami Chahkand Mohammad Sadra, Dadkhah Parisa Alsadat, Sheikhzadeh Farzad, Yaghoubi Shayan, Esmaeilpour Moallem Fatemeh, Deyhimi Mitra Sadat, Arab Bafrani Melika, Shahrokhi Mehregan, Nasrollahizadeh Amir
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Student Research Committee, Golestan University of Medical Sciences, Gorgan, Iran.
Front Pharmacol. 2025 May 15;16:1438318. doi: 10.3389/fphar.2025.1438318. eCollection 2025.
This study seeks to compare the effectiveness of Semaglutide compared to Liraglutide, Dulaglutide, or Tirzepatide. Additionally, it aims to investigate the implications of transitioning from Dulaglutide or Liraglutide to Semaglutide.
We searched PubMed, Scopus, Cochrane Library, Google Scholar, and Web of Science (ClinicalTrials.gov for unpublished records) from their inception to 5 February 2025, including observational cohort studies and randomized controlled trials. Analyses were conducted using Review Manager (RevMan) version 5.4.1 and STATA 17.
The meta-analysis comprised 16 studies and 5,997 patients. Semaglutide significantly reduced hemoglobin A1c (HbA1c) levels compared to Liraglutide (0.56; 95% CI: 0.19-0.94; p < 0.001). However, no significant differences were observed between Semaglutide and Liraglutide in terms of fasting blood sugar (FBS), body mass index (BMI), and weight change. In comparison to Dulaglutide, Semaglutide displayed superior efficacy in reducing HbA1c levels (3.72; 95% CI: 0.02-7.41; p = 0.05) and FBS (2.66; 95% CI: 0.26-5.07; p = 0.03). However, no significant differences were found in weight and BMI change. Tirzepatide exhibited a notable advantage over Semaglutide in reducing HbA1c levels (-0.45; 95% CI: -0.88 to -0.02; p = 0.04). However, no clear superiority was observed for weight and FBS change. Transitions from Liraglutide to Semaglutide did not significantly impact HbA1c levels. However, weight loss (2.48; 95% CI: 0.45-4.51; p = 0.02) and reduced FBS levels (10.76; 95% CI: 0.55-20; p = 0.04) were observed. Transitioning from Dulaglutide to Semaglutide did not significantly affect HbA1c levels and weight change.
While the precise source of heterogeneity remains elusive across most studies, analyses consistently demonstrate Semaglutide's superior efficacy compared to Liraglutide in reducing both HbA1c levels and weight. Moreover, it presents advantages over Dulaglutide, specifically in lowering FBS levels. However, Tirzepatide surpasses Semaglutide in its efficacy for reducing HbA1c levels.
本研究旨在比较司美格鲁肽与利拉鲁肽、度拉糖肽或替尔泊肽的有效性。此外，其目的是调查从度拉糖肽或利拉鲁肽转换为司美格鲁肽的影响。
我们检索了从创刊至2025年2月5日的PubMed、Scopus、Cochrane图书馆、谷歌学术和科学网（ClinicalTrials.gov获取未发表记录），包括观察性队列研究和随机对照试验。使用Review Manager（RevMan）5.4.1版和STATA 17进行分析。
荟萃分析纳入了16项研究和5997名患者。与利拉鲁肽相比，司美格鲁肽显著降低了糖化血红蛋白（HbA1c）水平（0.56；95%置信区间：0.19 - 0.94；p < 0.001）。然而，在空腹血糖（FBS）、体重指数（BMI）和体重变化方面，司美格鲁肽与利拉鲁肽之间未观察到显著差异。与度拉糖肽相比，司美格鲁肽在降低HbA1c水平（3.72；95%置信区间：0.02 - 7.41；p = 0.05）和FBS（2.66；95%置信区间：0.26 - 5.07；p = 0.03）方面显示出更高的疗效。然而，在体重和BMI变化方面未发现显著差异。替尔泊肽在降低HbA1c水平方面比利拉鲁肽具有显著优势（-0.45；95%置信区间：-0.88至-0.02；p = 0.04）。然而，在体重和FBS变化方面未观察到明显优势。从利拉鲁肽转换为司美格鲁肽对HbA1c水平没有显著影响。然而，观察到体重减轻（2.48；95%置信区间：0.45 - 4.51；p = 0.02）和FBS水平降低（10.76；95%置信区间：0.55 - 20；p = 0.04）。从度拉糖肽转换为司美格鲁肽对HbA1c水平和体重变化没有显著影响。
虽然大多数研究中异质性的确切来源仍不明确，但分析一致表明，与利拉鲁肽相比，司美格鲁肽在降低HbA1c水平和体重方面具有更高的疗效。此外，它比度拉糖肽具有优势，特别是在降低FBS水平方面。然而，替尔泊肽在降低HbA1c水平的疗效上超过司美格鲁肽。
