Author: Hormone Insight Editorial Team

Summary: In 178 adults with T2D (HbA1c 7.0-10.5%) on stable metformin, once-weekly semaglutide (0.25-1.0 mg) for 52 weeks produced numerically greater fat loss (3.4 vs 2.6 kg) and lean mass loss (2.3 vs 1.5 kg), but differences were not statistically significant; similar visceral fat reduction; greater total weight loss (5.3 vs 4.2 kg) compared to once-daily canagliflozin 300 mg, with GI adverse events more common with semaglutide; both preserved favorable fat-to-lean ratio. PICO Description Population 178 adults with T2D (HbA1c 7.0-10.5%) on metformin ≥1500 mg, eGFR ≥60. Intervention Once-weekly semaglutide escalated to 1.0 mg for 52 weeks. Comparison Once-daily canagliflozin…

Summary: In 1,748 adults with T2D (HbA1c 7.5-10.0%) inadequately controlled on basal insulin glargine and metformin, once-weekly semaglutide 1.0 mg for 52 weeks achieved greater HbA1c reduction (1.5% vs 1.2%, P<0.0001), weight loss vs gain (4.1 kg loss vs 2.8 kg gain, difference 7 kg), and more reaching target (<7%: 40.4% vs 30.2%) compared to thrice-daily insulin aspart, with dramatically lower clinically significant hypoglycemia (15.9% vs 43.4%, P<0.0001) but more GI side effects (nausea 14.8% vs 0.8%). PICO Description Population 1,748 adults with T2D (HbA1c 7.5-10.0%) on basal insulin glargine + metformin, 21 countries. Intervention Once-weekly semaglutide 1.0 mg added…

Summary: In 788 adults with T2D (HbA1c 7.0-10.5%) inadequately controlled on stable metformin, BMI ≥25, once-weekly semaglutide 1.0 mg for 52 weeks achieved greater HbA1c reduction (1.5% vs 1.0%, difference -0.49%, P<0.0001), weight loss (5.3 vs 4.2 kg), and more reaching <7.0% (66.1% vs 45.1%) compared to daily canagliflozin 300 mg, with more GI adverse events (46.9% vs 27.9%) but fewer genitourinary infections (2.6% vs 12.2%). PICO Description Population 788 adults with T2D (HbA1c 7.0-10.5%) on stable metformin ≥90 days, BMI ≥25. Intervention Semaglutide 1.0 mg subcutaneous weekly (titrated from 0.25 mg over 8 weeks). Comparison Canagliflozin 300 mg oral…

In patients with heart failure with preserved ejection fraction (HFpEF) and obesity, tirzepatide significantly reduced the composite risk of cardiovascular death or worsening heart failure and improved health status compared to placebo, though it was associated with higher gastrointestinal side effects.

In patients with type 2 diabetes, intensive blood-pressure control (targeting systolic BP <120 mm Hg) significantly reduced cardiovascular events compared to standard treatment (systolic BP <140 mm Hg), though it was associated with increased risks of symptomatic hypotension and hyperkalemia.

In children aged 6 to <12 years with obesity, liraglutide (3.0 mg daily, combined with lifestyle interventions) significantly reduced BMI and body weight compared to placebo with lifestyle interventions, though it was associated with increased gastrointestinal side effects.

In adults with moderate-to-severe obstructive sleep apnoea (OSA) and obesity, tirzepatide significantly reduced the apnea-hypopnea index (AHI) and body weight compared to placebo, with notable improvements in sleep-related outcomes and cardiovascular risk factors, albeit with increased gastrointestinal side effects.

In patients with obesity and knee osteoarthritis, once-weekly semaglutide (2.4 mg) significantly reduced body weight and pain compared to placebo, though it was associated with gastrointestinal side effects.

In adults with type 2 diabetes inadequately controlled with metformin (alone or with sulfonylurea), oral semaglutide (7 mg and 14 mg) significantly reduced HbA1c and body weight compared to sitagliptin over 26 weeks, while the 3 mg dose showed no significant benefit.

In patients with inadequately controlled type 2 diabetes on SGLT-2 inhibitors, adding semaglutide significantly improved HbA1c and reduced body weight compared to placebo, though it was associated with an increased frequency of gastrointestinal side effects.