Efficacy of polyethylene glycol loxenatide for type 2 diabetes mellitus patients: a systematic review and meta-analysis

Yibo Liu; Wenjing Ma; Hui Fu; Zhe Zhang; Yanyan Yin; Yongchun Wang; Wei Liu; Shaohong Yu; Zhongwen Zhang

doi:10.3389/fphar.2024.1235639

Efficacy of polyethylene glycol loxenatide for type 2 diabetes mellitus patients: a systematic review and meta-analysis

Front Pharmacol. 2024 Feb 26:15:1235639. doi: 10.3389/fphar.2024.1235639. eCollection 2024.

Authors

Yibo Liu^#^{1

2}, Wenjing Ma^#², Hui Fu³, Zhe Zhang⁴, Yanyan Yin⁵, Yongchun Wang², Wei Liu⁴, Shaohong Yu^{2

6}, Zhongwen Zhang⁷

Affiliations

¹ Department of Endocrinology and Metabology, Rehabilitation Hospital, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, The Third Affiliated Hospital of Shandong First Medical University, Jinan, China.
² Rehabilitation Hospital, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
³ Medical Integration and Practice Center, Shandong University, Jinan, China.
⁴ Shandong University of Traditional Chinese Medicine, Jinan, China.
⁵ Shandong Provincial Medical Association, Jinan, China.
⁶ Teaching and Research Section of Internal Medicine, College of Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China.
⁷ Shandong Provincial Key Laboratory for Rheumatic Disease and Translational Medicine, Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, The Third Affiliated Hospital of Shandong First Medical University, Jinan, China.

^# Contributed equally.

Abstract

Objective: Some studies have proved that polyethylene glycol loxenatide (PEG-Loxe) has significant effects on controlling blood glucose and body weight in patients with type 2 diabetes mellitus (T2DM), but there is still some controversy over the improvement of blood lipid profiles (BLP) and blood pressure (BP), and more evidences are needed to verify such effects. Therefore, this study was conducted to provide a comprehensive evaluation of the efficacy of PEG-Loxe in improving blood glucose (BG), BLP, BP, body mass index (BMI), and body weight (BW) in patients with T2DM for clinical reference. Methods: Randomized controlled trials (RCT) in which PEG-Loxe was applied to treat T2DM were retrieved by searching PubMed, Cochrane Library, Embase, Medline, Scopus, Web of Science, China National Knowledge Infrastructure, China Scientific Journal, Wanfang Data, and SinoMed databases. Outcome measures included BG, BLP, BP, BMI, and BW. RevMan 5.3 software was used to perform data analysis. Results: Eighteen trials were identified involving 2,166 patients. In experimental group 1,260 patients received PEG-Loxe alone or with other hypoglycemic agents, while in control group 906 patients received placebo or other hypoglycemic agents. In the overall analysis, PEG-Loxe significantly reduced the levels of glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2-h postprandial blood glucose (2-h PBG), BMI, and BW compared with control group. However, it had no obvious effect on total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Conclusion: PEG-Loxe has better hypoglycemic effects compared with placebo in patients with T2DM, but could not significantly improved TG, LDL-C, HDL-C, SBP, and DBP. And the combination of conventional hypoglycemic drugs (CHD) and PEG-Loxe could more effectively improve the levels of HbA1c, FPG, 2-h PBG, TC, TG, BMI, and BW compared with CHD in T2DM patients. Systematic Review Registration: www.inplasy.com, identifier INPLASY202350106.

Keywords: blood glucose; blood lipid profiles; blood pressure; body mass index; body weight; meta-analysis; polyethylene glycol loxenatide; type 2 diabetes mellitus.

Grants and funding

This work was supported by the National Natural Science Foundation of China (no. 82000788), Key Technology Research and Development Program of Shandong (no. 2018GSF118176), Basic and Applied Basic Research Foundation of Guangdong Province (no. 2019A1515110023), Postdoctoral Research Foundation of China (no. 2021M702040), and Natural Science Foundation of Shandong Province (no. ZR2016HQ26).