Efficacy and safety of once‐weekly glucagon‐like peptide‐1 receptor agonists compared with exenatide and liraglutide in type 2 diabetes: a systemic review of randomised controlled trials

Summary Background Once‐weekly glucagon‐like peptide‐1 receptor agonists ( GLP ‐1 RA s) have shown promising results in the treatment of type 2 diabetes. Herein, we compared the efficacy and safety of once‐weekly GLP ‐1 RA s with exenatide and liraglutide separately. Methods We systematically surveyed the pertinent literature using various databases. The randomised controlled trials that compared once‐weekly GLP ‐1 RA s with exenatide and liraglutide in type 2 diabetes were included. Our main end‐points were control of glycaemia, body weight, hypoglycaemia and gastrointestinal adverse events ( AE s). Results Our analysis included eight trials involving 5531 patients. Exenatide‐long‐acting release ( LAR ), dulaglutide and taspoglutide were more effective than twice‐daily exenatide in reducing glycosylated haemoglobin A1c (HbA1c) and fasting blood glucose ( FBG ) levels and achieving HbA1c targets (< 7.0% and ≤ 6.5%). Liraglutide was as effective as dulaglutide and more effective than exenatide‐ LAR and albiglutide in controlling glycaemia. With regard to the effectiveness in decreasing body weight, exenatide‐ LAR , dulaglutide and taspoglutide were similar to exenatide whereas exenatide‐ LAR , dulaglutide and albiglutide were inferior to liraglutide. Once‐weekly GLP ‐1 RA s, exenatide and liraglutide resulted in a similar incidence of hypoglycaemia and of gastrointestinal, serious, or other AE s. Conclusions Once‐weekly GLP ‐1 RA s were more effective in controlling glycaemia and equally effective in decreasing body weight than twice‐daily exenatide but were inferior to liraglutide in controlling these two parameters (dulaglutide was similar with liraglutide in controlling glycaemia). Once‐weekly GLP ‐1 RA s, exenatide and liraglutide had a similar risk of causing AE s.