부산대학교 도서관

Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are known to reduce weight in patients with overweight or obesity. However, their effect on systolic blood pressure (SBP) remains less well-established. We conducted a network meta-analysis to evaluate the effect of different drug-dose combinations of GLP-1 RAs on SBP in this population.Methods: Electronic databases were searched through January 2022 for RCTs which evaluated the efficacy of different doses of semaglutide, liraglutide, efpeglenatide, and exenatide in obese patients with and without T2DM. Systolic blood pressure (SBP) was chosen as the primary endpoint. A frequentist network meta-analysis using random-effects model was conducted, and pooled estimates were reported as mean differences (MD) with 95% confidence intervals (CI).Results: A total of 20 RCTs were included in the analysis. Among individuals with T2DM, liraglutide <2 mg once daily (QD) showed the greatest reduction in SBP (MD: -3.78 [-5.63; -1.15]), followed by exenatide 10 ug twice daily (BID) (MD: -3.39 [-5.63; -1.15]), and semaglutide ≥1mg once weekly (QW) (MD: -3.28 [–5.68; –0.88]), when compared with placebo. Among individuals without diabetes, efpeglenatide ≤ 6 mg QW showed the greatest reduction in SBP (MD: -6.00 [-9.89; -2.11]), followed by semaglutide ≥ 1 mg QW (MD: -4.54 [–5.69; –3.39]), and semaglutide <1mg QW (MD: -4.51 [–5.49; –3.54]). The figure shows how each drug/dose combination compares with others.Conclusions: This network meta-analysis suggests liraglutide <2mg QD is the most efficacious GLP-1 RA in lowering SBP in obese patients with T2DM. For obese patients without diabetes, efpeglenatide ≤6mg QW is the most effective.