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Glucagon-like peptide-1 receptor agonists: a systematic review of comparative effectiveness research
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) act by increasing insulin secretion, decreasing glucagon secretion, slowing gastric emptying, and increasing satiety. OBJECTIVE: Published evidence directly comparing GLP-1RAs with other approved treatments for type 2 diabetes (T2D) wa...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389657/ https://www.ncbi.nlm.nih.gov/pubmed/28435305 http://dx.doi.org/10.2147/DMSO.S130834 |
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author | Levin, Philip A Nguyen, Hiep Wittbrodt, Eric T Kim, Seoyoung C |
author_facet | Levin, Philip A Nguyen, Hiep Wittbrodt, Eric T Kim, Seoyoung C |
author_sort | Levin, Philip A |
collection | PubMed |
description | BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) act by increasing insulin secretion, decreasing glucagon secretion, slowing gastric emptying, and increasing satiety. OBJECTIVE: Published evidence directly comparing GLP-1RAs with other approved treatments for type 2 diabetes (T2D) was systematically reviewed. METHODS: A literature search was performed using MEDLINE and Embase databases to identify papers comparing GLP-1RAs with other classes of glucose-lowering therapy in patients with T2D. RESULTS: Of the 1303 papers identified, 57 met the prespecified criteria for a high-quality clinical trial or retrospective study. The efficacy and tolerability of approved GLP-1RAs (exenatide twice daily or once weekly, dulaglutide, liraglutide, lixisenatide, and albiglutide) were compared with insulin products (23 prospective studies + seven retrospective studies), dipeptidyl peptidase-4 inhibitors (11 prospective studies + three retrospective studies), sulfonylureas (nine prospective studies + one retrospective study), thiazolidinediones (five prospective studies), and metformin (two prospective studies). GLP-1RAs are effective as a second-line therapy in improving glycemic parameters in patients with T2D. Reductions in glycated hemoglobin from baseline with GLP-1RAs tended to be greater or similar compared with insulin therapy. GLP-1RAs were consistently more effective in reducing body weight than most oral glucose-lowering drugs and insulin and were associated with lower hypoglycemia risk versus insulin or sulfonylureas. GLP-1RAs improved cardiovascular risk factors, and preliminary data suggest they improve cardiovascular outcomes in patients with T2D compared with oral glucose-lowering drugs. However, results from ongoing studies are awaited to confirm these early findings. CONCLUSION: This systematic review found that GLP-1RAs are an effective class of glucose-lowering drugs for T2D. |
format | Online Article Text |
id | pubmed-5389657 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-53896572017-04-21 Glucagon-like peptide-1 receptor agonists: a systematic review of comparative effectiveness research Levin, Philip A Nguyen, Hiep Wittbrodt, Eric T Kim, Seoyoung C Diabetes Metab Syndr Obes Review BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) act by increasing insulin secretion, decreasing glucagon secretion, slowing gastric emptying, and increasing satiety. OBJECTIVE: Published evidence directly comparing GLP-1RAs with other approved treatments for type 2 diabetes (T2D) was systematically reviewed. METHODS: A literature search was performed using MEDLINE and Embase databases to identify papers comparing GLP-1RAs with other classes of glucose-lowering therapy in patients with T2D. RESULTS: Of the 1303 papers identified, 57 met the prespecified criteria for a high-quality clinical trial or retrospective study. The efficacy and tolerability of approved GLP-1RAs (exenatide twice daily or once weekly, dulaglutide, liraglutide, lixisenatide, and albiglutide) were compared with insulin products (23 prospective studies + seven retrospective studies), dipeptidyl peptidase-4 inhibitors (11 prospective studies + three retrospective studies), sulfonylureas (nine prospective studies + one retrospective study), thiazolidinediones (five prospective studies), and metformin (two prospective studies). GLP-1RAs are effective as a second-line therapy in improving glycemic parameters in patients with T2D. Reductions in glycated hemoglobin from baseline with GLP-1RAs tended to be greater or similar compared with insulin therapy. GLP-1RAs were consistently more effective in reducing body weight than most oral glucose-lowering drugs and insulin and were associated with lower hypoglycemia risk versus insulin or sulfonylureas. GLP-1RAs improved cardiovascular risk factors, and preliminary data suggest they improve cardiovascular outcomes in patients with T2D compared with oral glucose-lowering drugs. However, results from ongoing studies are awaited to confirm these early findings. CONCLUSION: This systematic review found that GLP-1RAs are an effective class of glucose-lowering drugs for T2D. Dove Medical Press 2017-04-04 /pmc/articles/PMC5389657/ /pubmed/28435305 http://dx.doi.org/10.2147/DMSO.S130834 Text en © 2017 Levin et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Review Levin, Philip A Nguyen, Hiep Wittbrodt, Eric T Kim, Seoyoung C Glucagon-like peptide-1 receptor agonists: a systematic review of comparative effectiveness research |
title | Glucagon-like peptide-1 receptor agonists: a systematic review of comparative effectiveness research |
title_full | Glucagon-like peptide-1 receptor agonists: a systematic review of comparative effectiveness research |
title_fullStr | Glucagon-like peptide-1 receptor agonists: a systematic review of comparative effectiveness research |
title_full_unstemmed | Glucagon-like peptide-1 receptor agonists: a systematic review of comparative effectiveness research |
title_short | Glucagon-like peptide-1 receptor agonists: a systematic review of comparative effectiveness research |
title_sort | glucagon-like peptide-1 receptor agonists: a systematic review of comparative effectiveness research |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389657/ https://www.ncbi.nlm.nih.gov/pubmed/28435305 http://dx.doi.org/10.2147/DMSO.S130834 |
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