Glucagon-like peptide-1 receptor agonists: a systematic review of comparative effectiveness research

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Glucagon-like peptide-1 receptor agonists: a systematic review of comparative effectiveness research

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Title: Glucagon-like peptide-1 receptor agonists: a systematic review of comparative effectiveness research
Author: Levin, Philip A; Nguyen, Hiep; Wittbrodt, Eric T; Kim, Seoyoung C

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Citation: Levin, Philip A, Hiep Nguyen, Eric T Wittbrodt, and Seoyoung C Kim. 2017. “Glucagon-like peptide-1 receptor agonists: a systematic review of comparative effectiveness research.” Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 10 (1): 123-139. doi:10.2147/DMSO.S130834. http://dx.doi.org/10.2147/DMSO.S130834.
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Abstract: 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.
Published Version: doi:10.2147/DMSO.S130834
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389657/pdf/
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:32630703
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