Comparison of the effectiveness and safety of GLP-1 receptor agonists for type 2 diabetes mellitus patients with overweight/obesity: A systematic review and network meta-analysis

• Published in: Diabetes research and clinical practice 2025-01, p.111999, Article 111999
• Main Authors: Wen, Zhige, Sun, Wenjie, Wang, Haoshuo, Chang, Ruiting, Wang, Jialing, Song, Changheng, Zhang, Shan, ni, Qing, An, Xuedong
• Format: Article
• Language: English
• Subjects: GLP-1 Receptor Agonists; Network Meta-Analysis; Overweight/Obesity; Systematic Review; Type 2 Diabetes Mellitus
• ISSN: 0168-8227; 1872-8227; 1872-8227
• DOI: 10.1016/j.diabres.2025.111999

To evaluate the effectiveness and safety of different Glucagon-like peptide-1 receptor agonists (GLP-1RAs) in treating type 2 diabetes mellitus (T2DM) with overweight/obesity using a systematic review and network meta-analysis. We searched PubMed, Embase, Cochrane Library, and Web of Science up to December 20, 2024, for randomized controlled trials (RCTs) involving T2DM patients with overweight/obesity treated with GLP-1RAs, with the control group receiving either a placebo or another GLP-1RA. We conducted a network meta-analysis assessed evidence using CINeMA. A total of 4548 articles were retrieved, and 41 RCTs were included, comprising 15,126 patients and 13 different GLP-1RAs. Tirzepatide showed superior effects in lowering blood glucose (Compared with placebo, increased glycated hemoglobin: −1.64 (−1.94, −1.35), increased fasting blood glucose: −2.10 (−2.95, −1.25)) and weight loss (Compared with placebo, increased weight: −9.89 (−11.29, −8.49), rincreased BMI: −3.85 (−4.71, −2.99)). However, clinical efficacy of GLP-1RAs in lipid levels, blood pressure, and pancreatic function was not widely observed. Adverse reactions were significant with GLP-1RAs, but overall acceptable. GLP-1RAs demonstrate efficacy and safety in T2DM patients with overweight/obesity, with certain advantages over other drugs. However, due to limitations in the number and quality of included studies, conclusions should be interpreted with caution.