Hormonal
Once-weekly semaglutide (0.5 mg and 1.0 mg) as an add-on to metformin significantly improves glycemic control (HbA1c), reduces body weight, and lowers blood pressure compared to once-daily sitagliptin in patients with type 2 diabetes.
For patients with Type 2 Diabetes on metformin who need better blood sugar and weight control, switching to once-weekly semaglutide is more effective than switching to the oral drug sitagliptin. Semaglutide lowers HbA1c, weight, and blood pressure more significantly. However, be aware that semaglutide carries a higher risk of side effects and treatment discontinuation compared to sitagliptin.
the findings revealed that once-weekly semaglutide showed substantially improved hba1c (WMD: −0.98; 95% ci: −1.28, −0.69, p-value: < 0.0001; i2: 100%), systolic (WMD: −3.73; 95% ci: −5.42, −2.04, p-value: <0.0001; i2: 100%) and diastolic blood pressures (WMD: −0.66; 95% ci: −1.02, −0.29, p-value: 0.0005; i2: 100%), and body weight (WMD: −3.17; 95% ci: −3.84, −2.49, p-value: <0.00001; i2: 100%) compared to once-daily sitagliptin.
Why this rating
Meta-analysis of 3 RCTs with 2401 participants, though heterogeneity was high (I2=100%).
Source
Comparative efficacy and safety profile of once-weekly Semaglutide versus once-daily Sitagliptin as an add-on to metformin in patients with type 2 diabetes: a systematic review and meta-analysis
Tirath Patel et al. · Annals of Medicine · 2023
DOI 10.1080/07853890.2023.2239830
More from this paper
- Once-weekly semaglutide treatment is associated with a significant increase in pulse rate compared to once-daily sitagliptin.Good
- Semaglutide treatment is associated with a higher risk of total adverse events and premature treatment discontinuation compared to sitagliptin, although the risk of serious adverse events is not significantly different.Good
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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