Semaglutide vs. dulaglutide for glycemic and weight control in patients with type 2 diabetes mellitus: A systematic review and meta‑analysis

Xia,Lili; Li,Huihua; Huang,Shan; Shen,Lisha

doi:10.3892/br.2024.1913

Semaglutide vs. dulaglutide for glycemic and weight control in patients with type 2 diabetes mellitus: A systematic review and meta‑analysis

Authors:
- Lili Xia
- Huihua Li
- Shan Huang
- Lisha Shen
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Affiliations: Department of Endocrinology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, P.R. China
Published online on: December 20, 2024 https://doi.org/10.3892/br.2024.1913
Article Number: 35
Copyright: © Xia et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The present systematic review and meta‑analysis aimed to evaluate the effectiveness of semaglutide and dulaglutide for glycemic control and weight loss in patients with type 2 diabetes mellitus (T2DM). A thorough literature search was conducted using several databases from inception until the end of July 2024. The primary outcome was the difference in glycated hemoglobin levels from the initial measurement between the groups. By contrast, the secondary outcome was the effect of the medications on body weight loss (change in body weight from baseline) during the treatment period. Appropriate statistical tests were employed to reach study endpoints. The results showed no statistically significant difference in glycemic control achievement between the two medications in patients with T2DM. Semaglutide demonstrated higher efficacy in inducing weight loss; however, sensitivity analysis indicated that the weight loss efficacy results should be interpreted cautiously. The study acknowledges the high heterogeneity and low quality among the studies included in the meta‑analysis and the potential impact of individual studies on the outcome. Despite these limitations, the findings suggested that semaglutide may be a more favorable treatment option for patients with T2DM requiring weight management and glycemic control. Further research is needed to investigate the long‑term benefits of glucagon‑like peptide‑1 receptor agonists and individual factors that may influence treatment response and outcomes.

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1	Tönnies T, Rathmann W, Hoyer A, Brinks R and Kuss O: Quantifying the underestimation of projected global diabetes prevalence by the International Diabetes Federation (IDF) Diabetes Atlas. BMJ Open Diabetes Res Care. 9(e002122)2021.PubMed/NCBI View Article : Google Scholar
2	American-diabetes-association. Improving care and promoting health in populations: Standards of medical care in diabetes-2021. Diabetes Care. 44:S7–S14. 2021.PubMed/NCBI View Article : Google Scholar
3	Campbell JE and Drucker DJ: Pharmacology, physiology, and mechanisms of incretin hormone action. Cell Metab. 17:819–837. 2013.PubMed/NCBI View Article : Google Scholar
4	Nauck MA and Meier JJ: The incretin effect in healthy individuals and those with type 2 diabetes: Physiology, pathophysiology, and response to therapeutic interventions. Lancet Diabetes Endocrinol. 4:525–536. 2016.PubMed/NCBI View Article : Google Scholar
5	Hinnen D: Glucagon-like peptide 1 receptor agonists for type 2 diabetes. Diabetes Spectr. 30:202–210. 2017.PubMed/NCBI View Article : Google Scholar
6	Seijas-Amigo J, Salgado-Barreira Á, Castelo-Dominguez R, Pérez-Álvarez MT, Ponce-Piñón B, Fernández-Silva M, Rodríguez-Barreiro M, Pereira-Pía M, Iglesias-Moreno JM, Gago-García M, et al: Differences in weight loss and safety between the glucagon-like peptide-1 receptor agonists: A non-randomized multicenter study from the titration phase. Prim Care Diabetes. 17:366–372. 2023.PubMed/NCBI View Article : Google Scholar
7	Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, et al: The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 372(n71)2021.PubMed/NCBI View Article : Google Scholar
8	Kononenko IV, Smirnova OM, Mayorov AY and Shestakova MV: Classification of diabetes. World Health Organization 2019. What's new? Diabetes Mellitus. 23:329–339. 2020.
9	American-diabetes-association. 2. Classification and diagnosis of diabetes: Standards of medical care in diabetes-2022. Diabetes Care. 45:S17–S38. 2022.PubMed/NCBI View Article : Google Scholar
10	Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JAC, et al: The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 343(d5928)2011.PubMed/NCBI View Article : Google Scholar
11	Higgins JP and Green S (eds): Cochrane handbook for systematic reviews of interventions. The Cochrane Collaboration, 2008.
12	Higgins JP, Thompson SG, Deeks JJ and Altman DG: Measuring inconsistency in meta-analyses. BMJ. 327:557–560. 2003.PubMed/NCBI View Article : Google Scholar
13	Graham PL and Moran JL: Robust meta-analytic conclusions mandate the provision of prediction intervals in meta-analysis summaries. J Clin Epidemiol. 65:503–510. 2012.PubMed/NCBI View Article : Google Scholar
14	Bloch MH: Meta-analysis and moderator analysis: Can the field develop further? J Am Acad Child Adolesc Psychiatry. 53:135–137. 2014.PubMed/NCBI View Article : Google Scholar
15	Pratley RE, Aroda VR, Lingvay I, Lüdemann J, Andreassen C, Navarria A and Viljoen A: SUSTAIN 7 investigators. Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): A randomised, open-label, phase 3b trial. Lancet Diabetes Endocrinol. 6:275–286. 2018.PubMed/NCBI View Article : Google Scholar
16	Yabe D, Nakamura J, Kaneto H, Deenadayalan S, Navarria A, Gislum M and Inagaki N: PIONEER 10 Investigators. Safety and efficacy of oral semaglutide versus dulaglutide in Japanese patients with type 2 diabetes (PIONEER 10): An open-label, randomised, active-controlled, phase 3a trial. Lancet Diabetes Endocrinol. 8:392–406. 2020.PubMed/NCBI View Article : Google Scholar
17	Iijima T, Shibuya M, Ito Y and Terauchi Y: Effects of switching from liraglutide to semaglutide or dulaglutide in patients with type 2 diabetes: A randomized controlled trial. J Diabetes Investig. 14:774–781. 2023.PubMed/NCBI View Article : Google Scholar
18	Iacobellis G and Villasante Fricke AC: Effects of semaglutide versus dulaglutide on epicardial fat thickness in subjects with type 2 diabetes and obesity. J Endocr Soc. 4(bvz042)2020.PubMed/NCBI View Article : Google Scholar
19	Takahashi Y, Nomoto H, Yokoyama H, Takano Y, Nagai S, Tsuzuki A, Cho KY, Miya A, Kameda H, Takeuchi J, et al: Improvement of glycaemic control and treatment satisfaction by switching from liraglutide or dulaglutide to subcutaneous semaglutide in patients with type 2 diabetes: A multicentre, prospective, randomized, open-label, parallel-group comparison study (SWITCH-SEMA 1 study). Diabetes Obes Metab. 25:1503–1511. 2023.PubMed/NCBI View Article : Google Scholar
20	Patoulias D, Popovic DS, Stoian AP, Janez A, Sahebkar A and Rizzo M: Effect of semaglutide versus other glucagon-like peptide-1 receptor agonists on cardio-metabolic risk factors in patients with type 2 diabetes: A systematic review and meta-analysis of head-to-head, phase 3, randomized controlled trials. J Diabetes Complications. 37(108529)2023.PubMed/NCBI View Article : Google Scholar
21	Shi FH, Li H, Cui M, Zhang ZL, Gu ZC and Liu XY: Efficacy and safety of once-weekly semaglutide for the treatment of type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials. Front Pharmacol. 9(576)2018.PubMed/NCBI View Article : Google Scholar
22	Mishriky BM, Cummings DM, Powell JR, Sewell KA and Tanenberg RJ: Comparing once-weekly semaglutide to incretin-based therapies in patients with type 2 diabetes: A systematic review and meta-analysis. Diabetes Metab. 45:102–109. 2019.PubMed/NCBI View Article : Google Scholar
23	Witkowski M, Wilkinson L, Webb N, Weids A, Glah D and Vrazic H: A systematic literature review and network meta-analysis comparing once-weekly semaglutide with other glp-1 receptor agonists in patients with type 2 diabetes previously receiving 1-2 oral anti-diabetic drugs. Diabetes Ther. 9:1149–1167. 2018.PubMed/NCBI View Article : Google Scholar
24	Tang Y, Zhang L, Zeng Y, Wang X and Zhang M: Efficacy and safety of tirzepatide in patients with type 2 diabetes: A systematic review and meta-analysis. Front Pharmacol. 13(1016639)2022.PubMed/NCBI View Article : Google Scholar
25	Andreadis P, Karagiannis T, Malandris K, Avgerinos I, Liakos A, Manolopoulos A, Bekiari E, Matthews DR and Tsapas A: Semaglutide for type 2 diabetes mellitus: A systematic review and meta-analysis. Diabetes Obes Metab. 20:2255–2263. 2018.PubMed/NCBI View Article : Google Scholar
26	West SL, Gartlehner G, Mansfield AJ, Poole C, Tant E, Lenfestey N, Lux LJ, Amoozegar J, Morton SC, Carey TC, et al: AHRQ methods for effective health care. In: Comparative effectiveness review methods: Clinical heterogeneity. Agency for Healthcare Research and Quality (US), Rockville (MD), 2010.
27	Borenstein M: In a meta-analysis, the I-squared statistic does not tell us how much the effect size varies. J Clin Epidemiol. 152:281–284. 2022.PubMed/NCBI View Article : Google Scholar