Once-weekly glucagon-like peptide-1 receptor agonists (GLP-1RAs) differ in their efficacy and safety profiles, according to new research by the University of Leicester.
GLP-1RAs are a relatively new class of drugs that stimulate insulin and inhibit glucagon secretion, slow gastric emptying, and reduce food intake. While the first approved GLP-1RAs are administered as subcutaneous daily injections, more recently GLP-1RAs available via once-weekly administration have emerged, reducing the number of injections and side effects and potentially improving patient compliance.
In clinical studies, these drugs improve glucose control and reduce body weight, without an increased risk for hypoglycaemia. To date, however, no direct comparisons between once-weekly GLP-1RAs are available.
The research – carried out by the university’s Diabetes Research Centre, which is based at the Leicester Diabetes Centre – used an innovative method to evaluate the efficacy and adverse effects of once-weekly GLP-1RAs in adults with Type 2 diabetes.
Researcher Dr Francesco Zaccardi and colleagues conducted a network meta-analysis of randomised trials. In the absence of direct evidence, network meta-analysis is an increasingly used statistical methodology that allows the estimation of the comparative effectiveness of multiple treatments.
Dr Zaccardi concluded:
Compared to other available once-weekly GLP-1RAs, dulaglutide 1.5mg and once weekly exenatide showed a greater reduction of HbA1c and fasting plasma glucose. The risk of hypoglycaemia among once-weekly GLP-1RAs was comparable. Taspoglutide, one of the agents evaluated, has already been withdrawn from the market for high rates of nausea, and this has been confirmed in the meta-analysis.