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胰高血糖素样肽-1受体激动剂治疗2型糖尿病

Aims: Integrating evidence from all randomized controlled trials (RCTs) of glucagon-like peptide-1 receptor agonists (GLP-1s) to assess the safety of cardiovascular disease (CVD) and effcacy of glycemic control.
 
Methods: Besides performingpairwise meta-analysis, network meta-analysis ofall RCTs was used to combine direct and indirect estimates of the effect of GLP-1 with placebo, active comparator drugs (ACD),oranotherGLP-1agent with treatment duration z8weeksin T2DM patients, 15,883 for CVD safety from 45 RCTs and 14,136 for glycemic control from 36 RCTs. Results: For CVD safety, both of the results from pairwise and network meta-analysis failed to demonstrate significant difference between any two comparators. For glycemic control, the effect of any GLP-1was better than placebo,butnodifference wasfound betweenGLP-1s. We also found that liraglutide was the only GLP-1 drug shown to be more effective on improving glycemic control than ACD and exenatide. The results based on directorindirect estimates were similar for two outcomes.
 
Conclusion: Our network meta-analysis provides a complete picture of the associations between GLP-1s, ACD and placebo on CVD safety and glycemic control. The GLP-1s are promising candidates for the treatment of T2DM, but more long-term trials are needed to confrm potential CVD safety.