PMID- 37606127
OWN - NLM
STAT- MEDLINE
DCOM- 20230823
LR  - 20231018
IS  - 2284-0729 (Electronic)
IS  - 1128-3602 (Linking)
VI  - 27
IP  - 15
DP  - 2023 Aug
TI  - Is tirzepatide 15 mg the preferred treatment strategy for type 2 diabetes? A 
      meta-analysis and trial-sequence-analysis.
PG  - 7164-7179
LID - 33290 [pii]
LID - 10.26355/eurrev_202308_33290 [doi]
AB  - OBJECTIVE: The study aims to evaluate tirzepatide's efficacy and safety in 
      treating type 2 diabetes by meta-analysis and trial-sequential-analysis (TSA). 
      MATERIALS AND METHODS: Eight databases were searched for clinical trials on 
      tirzepatide for type 2 diabetes with a time limit of November 2022. Revman5.3 and 
      TSA 0.9.5.10 Beta were selected for meta-analysis and TSA. RESULTS: Compared with 
      placebo, the meta-analysis demonstrated that tirzepatide 15 mg reduced 
      hemoglobin-type-A1C (HbA1c) (p<0.00001), fasting-serum-glucose (FSG) (p<0.00001), 
      and weight (p<0.00001). Compared with insulin, tirzepatide 15 mg reduced HbA1c 
      (p<0.00001), FSG (p<0.00007), and weight (p<0.00001). Compared with 
      glucagon-like-peptide-1 receptor-agonist (GLP-1 RA), tirzepatide 15 mg reduced 
      HbA1c (p=0.00004), FSG (p=0.001), and weight (p<0.00001). In safety endpoints, 
      the meta-analysis revealed that adverse events (AEs) of placebo, insulin and 
      GLP-1 RA were comparable to tirzepatide 15 mg. The total AEs (p=0.02) and 
      gastrointestinal (GI) AEs (p=0.03) were higher in tirzepatide 15 mg than in the 
      placebo, while hypoglycemia (<54 mg/dl) was comparable. The major adverse 
      cardiovascular events-4 (MACE-4) (p=0.03) and hypoglycemia (<54 mg/dl) 
      (p<0.00001) of tirzepatide 15 mg were lower when compared to insulin, while total 
      AEs (p=0.03) were increased. Compared with GLP-1 RA, tirzepatide 15 mg was 
      comparable in safety endpoints in total AEs and GI AEs, while hypoglycemia (<54 
      mg/dl) (p=0.04) was higher. TSA indicated that HgA1c, FSG, and weight benefits 
      were conclusive. In safety endpoints, only MACE-4 and hypoglycemia (<54 mg/dl) of 
      Tirzepatide 15 mg vs. Insulin were conclusive. Harbord regression of AEs 
      suggested no evident publication bias (p=0.618). CONCLUSIONS: Tirzepatide 15 mg 
      reduced HbA1c and weight more effectively than placebo, insulin, and GLP-1 RA. 
      Total AEs were higher than placebo and insulin but comparable to GLP-1 RA. 
      Tirzepatide 15 mg is a kind of optimal strategy to treat type 2 diabetes. 
      However, there is a need to focus on GI AEs.
FAU - Yang, X-Y
AU  - Yang XY
AD  - College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, 
      Hunan, China. daxiong20001977@163.com.
FAU - Yin, S
AU  - Yin S
FAU - Yu, Y-F
AU  - Yu YF
FAU - Hu, G
AU  - Hu G
FAU - Hang, F-Z
AU  - Hang FZ
FAU - Zhou, M-L
AU  - Zhou ML
FAU - Liu, P
AU  - Liu P
FAU - Jian, W-X
AU  - Jian WX
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PL  - Italy
TA  - Eur Rev Med Pharmacol Sci
JT  - European review for medical and pharmacological sciences
JID - 9717360
RN  - 89750-14-1 (Glucagon-Like Peptide 1)
RN  - 0 (Glycated Hemoglobin)
RN  - 0 (Insulin)
RN  - OYN3CCI6QE (tirzepatide)
SB  - IM
MH  - Humans
MH  - *Diabetes Mellitus, Type 2/drug therapy
MH  - *Glucagon-Like Peptide 1/adverse effects
MH  - Glycated Hemoglobin
MH  - Hypoglycemia
MH  - Insulin/adverse effects
MH  - Clinical Trials as Topic
EDAT- 2023/08/22 13:42
MHDA- 2023/08/23 06:42
CRDT- 2023/08/22 07:27
PHST- 2023/08/23 06:42 [medline]
PHST- 2023/08/22 13:42 [pubmed]
PHST- 2023/08/22 07:27 [entrez]
AID - 33290 [pii]
AID - 10.26355/eurrev_202308_33290 [doi]
PST - ppublish
SO  - Eur Rev Med Pharmacol Sci. 2023 Aug;27(15):7164-7179. doi: 
      10.26355/eurrev_202308_33290.