替尔泊肽治疗成人2型糖尿病疗效和安全性的Meta分析OA

Objective To systematically evaluate the efficacy and safety of tirzepatide compared with other types of antidiabetic drugs in adults with type 2 diabetes mellitus(T2DM).Methods PubMed,Embase,Cochrane Library,Web of Science,ClinicalTrials.gov,CNKI,Wanfang Database,VIP database and China Biology Medicine Disc were searched by computer.The randomized controlled trials(RCT)of tirzepatide 5 mg,10 mg,15 mg versus placebo or other antidiabetic drugs in the treatment of T2DM were collected.The search time limit was from the establishment of the database to September 2023.After literature screening,data extraction and quality evaluation,RevMan 5.4 software was used for Meta-analysis.Results A total of 10 RCT studies were included,with a total of 9 526 patients.The results of meta-analysis showed that compared with placebo,basal insulin and glucagon-like peptide-1 receptor agonist(GLP-1RA),tirzepatide was more effective in reducing patients'HbA1c,significantly improving the HbA1c compliance rate,and significantly reducing body weight,with statistical significance(P＜0.05).The effect was dose-dependent.In terms of safety,tirzepatide had a higher incidence of adverse events(AE),mainly gastrointestinal adverse events,but the incidence of hypoglycemia was lower than that of placebo[RR=0.65,95%CI(0.47,0.90),P＜0.05]and basal insulin[RR=0.56,95%CI(0.43,0.72),P＜0.05].Dose subgroup analysis showed that the occurrence of adverse reactions increased with the increase of dose.Conclusion Compared with placebo,basal insulin and GLP-1RA,tirzepatide has good hypoglycemic and weight loss effects in a dose-dependent manner,and does not significantly increase the risk of gastrointestinal reactions and hypoglycemia.