Hormonal
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.
Be prepared for a higher likelihood of side effects and stopping the medication early when starting semaglutide compared to sitagliptin. Most side effects are gastrointestinal. Slow dose escalation can help. However, serious adverse events are not significantly more common with semaglutide.
Regarding secondary outcomes, there was an elevated risk of total adverse events and premature treatment discontinuation with semaglutide. the risk of serious, severe, moderate, and mild adverse events did not significantly differ between the two treatments.
Why this rating
Meta-analysis of 3 RCTs.
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 (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.Good
- Once-weekly semaglutide treatment is associated with a significant increase in pulse rate compared to once-daily sitagliptin.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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