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Internal Medicine

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@Everyone In a network meta-analysis of 76 randomized trials, including 39,000 adults with type 2 diabetes and spanning at least 12 weeks, researchers evaluated the efficacy and safety of six U.S. FDA-approved glucagon-like peptide-1 (GLP-1) receptor agonists, three of which are also approved for obesity and overweight management. The findings revealed:

- Tirzepatide, a dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist, emerged as the most effective approved agent for managing both diabetes and obesity. Compared to placebo, tirzepatide showed significant mean reductions of -2.1% in glycosylated hemoglobin (HbA1c), -56 mg/dL in fasting blood glucose, and -8.5 kg in body weight.

- Semaglutide ranked as the second most effective for these indications, with mean differences of -1.4% in HbA1c, -36 mg/dL in fasting blood glucose, and -3.1 kg in body weight when compared to placebo.

- The combination of semaglutide and the amylin analog cagrilintide, still under investigation, was identified as the most effective for weight loss, achieving a mean reduction of 14.0 kg in body weight compared to placebo.

- The study also noted that most of the evaluated GLP-1 receptor agonists shared similar adverse effect profiles, predominantly gastrointestinal effects.

These results underscore the varying efficacy of GLP-1 receptor agonists in managing diabetes and obesity, highlighting tirzepatide's superior effectiveness among the approved options and the promising potential of investigational therapies like the semaglutide-cagrilintide combination for weight loss.

Ayham Alagha
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