Effect of long-acting versus short-acting glucagon-like peptide-1 receptor agonists on improving body weight and related metabolic parameters in type 2 diabetes: A head-to-head meta-analysis

Abstract

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) showed great value in treating nonalcoholic fatty liver disease (NAFLD). We aimed to compare the effectiveness of long-acting and short-acting GLP-1RAs on improving body weight and related metabolic parameters in patients with type 2 diabetes (T2DM) as a reference for the treatment of NAFLD with T2DM. Methods: We searched eligible randomized controlled trials (RCTs) in PubMed, Embase, Cochrane and web of science database until August 2023. The risk of bias of included RCTs were assessed by the Risk Assessment of Cochrane Review items. We mainly drew forest plots to compare the effects of long and short acting GLP-1 RAs using RevMan 5.4. Results: Twelve RCTs involving 2751 patients were included in our meta-analysis. Compared with short-acting GLP-1 RAs, the long-acting group was better in body weight (P < .00001, MD = −0.65, 95% confidence interval [CI] [−0.90, −0.40], I2 = 20%), and the same results in glycosylated hemoglobin (HbA1c) (P < .00001, MD = −0.43, 95% CI [−0.54, −0.33], I2 = 55%) and fasting plasma glucose (FPG) (P < .00001, MD = −0.77, 95% CI [−1.01, −0.52], I2 =70%). For the lipid parameters, long-acting drugs lowered cholesterol (TC) (P = .02, SMD = −0.19, 95% CI [−0.35, −0.03], I2 =57%) and low-density lipoprotein (LDL) (P = .02, SMD = −0.17, 95% CI [−0.33, −0.02], I2 =51%) more significantly compared with short-acting drugs. But treatment differences were not significant in triglycerides (TG) (P = .40, SMD = −0.05, 95% CI [−0.15, −0.06], I2 = 0%), and high-density lipoprotein (HDL) (P = .85, SMD = −0.01, 95% CI [−0.11, −0.09], I2 = 0%). Conclusion: Long-acting GLP-1RAs may be more promise than short-acting GLP-1RAs in improving weight and related metabolic parameters.

A Retrospective Analysis of Glucagon-Like Peptide 1 Receptor Agonists in Treating Type 2 Diabetes Mellitus Complicated by Nonalcoholic Fatty Liver Disease

“…There was no statistically significant difference in L/S, ALT, AST, GGT, TC, TG and HDL-C. In a meta-analysis, long-acting GLP-1RAs significantly reduced TC and LDL compared with short-acting GLP-1RAs, there was no significant difference in TG and HDL, but the forest plot indicated that long-acting drugs might be more valuable in reducing TG [18]. However, the meta-analysis did not compare the clinical indices between the ultra-long-acting group and the long-acting group.…”