ArticleDiabetes, metabolic syndrome and obesity : targets and therapy2025
Optimising GLP-1RA Efficacy: A Meta-Analysis of Baseline Age and HbA1c as Predictors of MACE Reduction in T2DM.
Article in Diabetes, metabolic syndrome and obesity : targets and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Predicted cardiovascular risk reduction with tirzepatide vs. semaglutide: interpretative considerations from the SURMOUNT-5European heart journal open · 2026Article
- Plasma GLP-1 (Glucagon-like Peptide-1) Depletion Is Correlated with Dysregulation of Adipocytokine in Type 2 Diabetic Patients With or Without Metabolic-Associated Fatty Liver Disease (MAFLD): A Cross-Sectional Study Related to Gender-Sex Disparities.International journal of molecular sciences · 2026Article
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Type 2 diabetes mellitus (T2DM) increases major adverse cardiovascular event (MACE) risk, requiring effective interventions. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce MACE, but the impact of baseline characteristics on their efficacy is unclear from previous analyses. Methods: This PRISMA-guided systematic review and meta-analysis included randomised controlled trials (RCTs) comparing GLP-1RAs with placebo in patients with T2DM, sourced from PubMed and Google Scholar. We extracted MACE hazard ratios (HR), 95% confidence intervals (CI), and baseline characteristics (age, BMI, SBP, HbA1c, eGFR, male proportion, diabetes duration, CVD prevalence). A random-effects model estimated pooled HR, with heterogeneity assessed via prediction intervals. Meta-regression identified moderators. Sensitivity analyses and the RoB 2 Tool assessed bias; GRADE evaluated the certainty of evidence. Results: Across 11 RCTs (83,536 participants), the pooled HR for MACE was 0.87 (95% CI: 0.81-0.93), indicating a 13% risk reduction with moderate heterogeneity (prediction interval: 0.79-0.96). After excluding T2DM duration due to multicollinearity, multivariate meta-regression identified age (p = 0.02) and HbA1c (p = 0.03) as significant moderators, which persisted after excluding FREEDOM-CVO (age, p = 0.03; HbA1c, p = 0.04). Baseline CVD prevalence did not moderate outcomes (p = 0.892). Bias was low; evidence certainty was moderate. Conclusion: GLP-1RAs reduce MACE in T2DM, particularly in older patients with lower baseline HbA1c. This fills a critical gap in prior meta-analyses by identifying actionable pre-treatment predictors that support personalised therapy. Protocol Registration: Ghosal et al INPLASY protocol 202580045. doi:10.37766/inplasy2025.8.0045 INPLASY202580045.
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