Hormonal
Weekly GLP-1 receptor agonists significantly reduce MACE risk in obese T2DM patients, whereas daily GLP-1 RAs do not show a significant reduction compared to placebo.
For obese diabetic patients, choosing a weekly GLP-1 injection (like dulaglutide or semaglutide) may offer better heart protection than daily options (like liraglutide or lixisenatide), according to this analysis. However, the difference between the two classes was not statistically significant when compared directly to each other.
In the participants with obesity and T2DM, weekly GLP-1 RAs (exenatide, dulaglutide, albiglutide, and subcutaneous semaglutide) reduced the risk of MACE versus placebo (RR 0.87 [0.78–0.95]), whereas daily GLP-1 RAs (lixisenatide, liraglutide, and oral semaglutide) did not (RR 0.93 [0.78–1.10]).
Why this rating
Sensitivity analysis of a subset of studies; heterogeneity was moderate to high.
Source
Systematic review and meta-analysis for prevention of cardiovascular complications using GLP-1 receptor agonists and SGLT-2 inhibitors in obese diabetic patients
Kazushi Uneda et al. · Scientific Reports · 2021
DOI 10.1038/s41598-021-89620-7
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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