Diabetes, Metabolic Syndrome and Obesity (Nov 2023)

Evaluating Glycemic Control Efficacy and Safety of the Oral Small Molecule Glucagon-Like Peptide 1 Receptor Agonist Danuglipron in Type 2 Diabetes Patients: A Systemic Review and Meta-Analysis

  • Fatima H,
  • Rangwala HS,
  • Mustafa MS,
  • Shafique MA,
  • Abbas SR,
  • Rizwan A,
  • Fadlalla Ahmed TK,
  • Arshad A

Journal volume & issue
Vol. Volume 16
pp. 3567 – 3578

Abstract

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Hareer Fatima,1 Hussain Sohail Rangwala,1 Muhammad Saqlain Mustafa,1 Muhammad Ashir Shafique,1 Syed Raza Abbas,2 Azra Rizwan,3 Tagwa Kalool Fadlalla Ahmed,4 Ainan Arshad3 1Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan; 2Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan; 3Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan; 4Department of Medicine, Ahfad University for Women, Omdurman, Al-Khartum, SudanCorrespondence: Tagwa Kalool Fadlalla Ahmed, Department of Medicine, Ahfad University for Women, PO Box 167, Omdurman, Al-Khartum, Sudan, Tel +923412127759, Email [email protected]: Diabetes Mellitus (DM) is a significant global health concern, with Type 2 DM (T2DM) being highly prevalent. Glucagon-Like Peptide 1 receptor agonists (GLP-1RA), such as Danuglipron, offer potential benefits in T2DM management. This meta-analysis examines the safety and efficacy of Danuglipron, focusing on adverse outcomes and glycemic parameters.Methods: A systematic search was conducted in PubMed, Scopus, and Cochrane Library for RCTs involving Danuglipron till August 2023, following PRISMA guidelines. The Cochrane risk-of-bias tool was used for quality assessment. Adverse outcomes (diarrhea, nausea, vomiting, headache, decreased appetite, dyspepsia, dizziness) and glycemic parameters like changes in HbA1C, fasting plasma glucose (FPG), and body weight were analyzed.Results: Four RCTs published from 2021 to 2023 were included. Both doses of Danuglipron were associated with diarrhea (RR=2.66, 90% CI: 1.32 to 5.35, p=0.02), nausea (RR=5.5, 90% CI: 3.4 to 8.88, p< 0.00001), and vomiting (RR=5.98, 90% CI: 2.93 to 12.23, p=0.0001). The 120mg dose showed decreased appetite (RR=3.46, 90% CI: 1.57 to 7.62, p=0.01), dyspepsia (RR=4.04, 90% CI: 1.93 to 8.43, p=0.002), and dizziness (RR=5.08, 90% CI: 1.45 to 17.82, p=0.03). Reductions in HbA1C (SMD − 1.09, 90% CI − 1.39 to − 0.8, p < 0.00001), FPG (SMD − 1.10, 90% CI − 1.46 to − 0.75, p < 0.00001), and body weight (SMD − 1.08, 90% CI − 1.42 to − 0.74, p < 0.00001) were observed for both doses.Conclusion: Danuglipron demonstrates potential for glycemic control and weight reduction in T2DM. Adverse outcomes include diarrhea, nausea, vomiting, and decreased appetite, with dose-related effects. Clinicians must weigh benefits against side effects when considering Danuglipron for T2DM management.Keywords: diabetes mellitus, glucagon-like peptide 1 receptor agonists, Danuglipron, adverse outcomes, glycemic parameters

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