汕头大学医学院学报2026，Vol.39Issue(1)：7-13,18,8.DOI:10.13401/j.cnki.jsumc.2026.01.002
聚乙二醇洛塞那肽与司美格鲁肽在2型糖尿病治疗中疗效和安全性对比的真实世界队列研究
Real-world cohort study on the efficacy and safety of polyethylene glycol loxenatide versus semaglutide in the treatment of type 2 diabetes mellitus
摘要
Abstract
Objective:To compare the long-term efficacy and safety of the once-weekly glucagon-like peptide-1 receptor agonists,polyethylene glycol loxenatide and semaglutide,in patients with suboptimally controlled type 2 diabetes mellitus in real-world clinical practice.Methods:This retrospective cohort study included patients with type 2 diabetes mellitus who initiated treatment with polyethylene glycol loxenatide(200 μg/week)or semaglutide(1.0 mg/week)at The First Affiliated Hospital of Shantou University Medical College between January 2021 and October 2022.After balancing baseline characteristics via 1∶1 propensity score matching,410 patients in each group were analyzed.The primary endpoint was the change from baseline in glycated hemoglobin(HbA1c)at 24 months.Changes in HbA1c,body weight,body mass index,low-density lipoprotein cholesterol,and systolic blood pressure at 3,6,12,and 24 months were compared between groups using a linear mixed model,and adverse drug reactions were recorded.Results:At 24 months,HbA1c decreased by 2.00%and 2.21%in the polyethylene glycol loxenatide and semaglutide groups,respectively,with no statistically significant between-group difference(-0.20%,95%CI:-0.34 to 0.06,P=0.114).However,semaglutide demonstrated consistently superior effects in reducing body weight(between-group difference at 24 months:-5.09 kg,P<0.001),low-density lipoprotein cholesterol(-0.48 mmol/L,P<0.001),and systolic blood pressure(-2.25 mmHg,P<0.001)compared to polyethylene glycol loxenatide.Regarding safety,the incidence of severe hypoglycemia was very low in both groups.During the first 3 months of treatment,the incidence of nausea,vomiting,and diarrhea was higher in the semaglutide group than in the polyethylene glycol loxenatide group(P<0.05).Conclusion:In this real-world study,polyethylene glycol loxenatide and semaglutide showed equivalent glucose-lowering efficacy over a 2-year treatment period.Semaglutide demonstrated clearer advantages in weight reduction and improvement of some cardiovascular metabolic risk factors,while polyethylene glycol loxenatide showed better gastrointestinal tolerability during the initial treatment phase.Clinical decisions should be based on individualized treatment goals.关键词
聚乙二醇洛塞那肽/司美格鲁肽/2型糖尿病/胰高血糖素样肽-1受体激动剂/真实世界研究Key words
polyethylene glycol loxenatide/semaglutide/type 2 diabetes mellitus/glucagon-like peptide-1 receptor agonist/real-world study分类
医药卫生引用本文复制引用
卓烨烨,余泽林,王亚力,蔡德..聚乙二醇洛塞那肽与司美格鲁肽在2型糖尿病治疗中疗效和安全性对比的真实世界队列研究[J].汕头大学医学院学报,2026,39(1):7-13,18,8.基金项目
中国医药教育协会临床用药卫生技术评估专项课题(2023WSJSPGZXKT-42) （2023WSJSPGZXKT-42）
