Efficacy and safety of once-weekly glucagon-like peptide-1 receptor agonists compared with exenatide and liraglutide in type 2 diabetes: a systemic review of randomised controlled trials

Int J Clin Pract. 2016 Aug;70(8):649-56. doi: 10.1111/ijcp.12847. Epub 2016 Jul 25.

Abstract

Background: Once-weekly glucagon-like peptide-1 receptor agonists (GLP-1RAs) have shown promising results in the treatment of type 2 diabetes. Herein, we compared the efficacy and safety of once-weekly GLP-1RAs with exenatide and liraglutide separately.

Methods: We systematically surveyed the pertinent literature using various databases. The randomised controlled trials that compared once-weekly GLP-1RAs with exenatide and liraglutide in type 2 diabetes were included. Our main end-points were control of glycaemia, body weight, hypoglycaemia and gastrointestinal adverse events (AEs).

Results: Our analysis included eight trials involving 5531 patients. Exenatide-long-acting release (LAR), dulaglutide and taspoglutide were more effective than twice-daily exenatide in reducing glycosylated haemoglobin A1c (HbA1c) and fasting blood glucose (FBG) levels and achieving HbA1c targets (< 7.0% and ≤ 6.5%). Liraglutide was as effective as dulaglutide and more effective than exenatide-LAR and albiglutide in controlling glycaemia. With regard to the effectiveness in decreasing body weight, exenatide-LAR, dulaglutide and taspoglutide were similar to exenatide whereas exenatide-LAR, dulaglutide and albiglutide were inferior to liraglutide. Once-weekly GLP-1RAs, exenatide and liraglutide resulted in a similar incidence of hypoglycaemia and of gastrointestinal, serious, or other AEs.

Conclusions: Once-weekly GLP-1RAs were more effective in controlling glycaemia and equally effective in decreasing body weight than twice-daily exenatide but were inferior to liraglutide in controlling these two parameters (dulaglutide was similar with liraglutide in controlling glycaemia). Once-weekly GLP-1RAs, exenatide and liraglutide had a similar risk of causing AEs.

Publication types

  • Comparative Study
  • Review
  • Systematic Review

MeSH terms

  • Diabetes Mellitus, Type 2* / drug therapy
  • Drug Administration Schedule
  • Exenatide
  • Gastrointestinal Diseases / chemically induced
  • Glucagon-Like Peptide-1 Receptor* / agonists
  • Glucagon-Like Peptides / administration & dosage
  • Glucagon-Like Peptides / adverse effects
  • Glucagon-Like Peptides / analogs & derivatives
  • Glycated Hemoglobin / metabolism
  • Humans
  • Hypoglycemia / chemically induced
  • Hypoglycemic Agents* / administration & dosage
  • Hypoglycemic Agents* / adverse effects
  • Immunoglobulin Fc Fragments / administration & dosage
  • Immunoglobulin Fc Fragments / adverse effects
  • Liraglutide* / administration & dosage
  • Liraglutide* / adverse effects
  • Peptides* / administration & dosage
  • Peptides* / adverse effects
  • Randomized Controlled Trials as Topic
  • Recombinant Fusion Proteins / administration & dosage
  • Recombinant Fusion Proteins / adverse effects
  • Risk Factors
  • Treatment Outcome
  • Venoms* / administration & dosage
  • Venoms* / adverse effects
  • Weight Loss / drug effects

Substances

  • dulaglutide
  • Exenatide
  • Glucagon-Like Peptide-1 Receptor
  • Glucagon-Like Peptides
  • Glycated Hemoglobin
  • Hypoglycemic Agents
  • Immunoglobulin Fc Fragments
  • Liraglutide
  • Peptides
  • Recombinant Fusion Proteins
  • taspoglutide
  • Venoms