title: Cardiovascular safety and glycemic control of glucagon-like peptide-1 receptor agonists for type 2 diabetes mellitus: a pairwise and network meta-analysis.
abstract: OBJECTIVE
  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 efficacy of glycemic control.
  
  
  METHODS
  Besides performing pairwise meta-analysis, network meta-analysis of all RCTs was used to combine direct and indirect estimates of the effect of GLP-1 with placebo, active comparator drugs (ACD), or another GLP-1 agent with treatment duration ≥8 weeks in 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-1 was better than placebo, but no difference was found between GLP-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 direct or indirect estimates were similar for two outcomes.
  
  
  CONCLUSIONS
  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 confirm potential CVD safety.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Sun
authors.forename: Kai
authors.initials: K
authors.lastname: Yu
authors.forename: Shanshan
authors.initials: S
authors.lastname: Wu
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Zhirong
authors.initials: Z
authors.lastname: Yang
authors.forename: Luwen
authors.initials: L
authors.lastname: Shi
authors.forename: Linong
authors.initials: L
authors.lastname: Ji
authors.forename: Siyan
authors.initials: S
authors.lastname: Zhan
mesh_terms: D002318:Cardiovascular Diseases / Q000150:complications / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D000067757:Glucagon-Like Peptide-1 Receptor; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D018027:Receptors, Glucagon / Q000819:agonists*
chemical_list: C000593833:GLP1R protein, human; D000067757:Glucagon-Like Peptide-1 Receptor; D007004:Hypoglycemic Agents; D018027:Receptors, Glucagon