Assessing the potential for precision medicine in body weight reduction with regard to type 2 diabetes mellitus therapies: A meta-regression analysis of 120 randomized controlled trials.

Abstract

AIMS:

To assess the potential for precision medicine in type 2 diabetes by quantifying the variability of body weight as response to pharmacological treatment and to identify predictors which could explain this variability.

METHODS:

We used randomized clinical trials (RCTs) comparing glucose-lowering drugs (including but not limited to sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists and thiazolidinediones) to placebo from four recent systematic reviews. RCTs reporting on body weight after treatment to allow for calculation of its logarithmic standard deviation (log[SD], i.e., treatment response heterogeneity) in verum (i.e., treatment) and placebo groups were included. Meta-regression analyses were performed with respect to variability of body weight after treatment and potential predictors.

RESULTS:

A total of 120 RCTs with a total of 43 663 participants were analysed. A slightly larger treatment response heterogeneity was shown in the verum groups, with a median log(SD) of 2.83 compared to 2.79 from placebo. After full adjustment in the meta-regression model, the difference in body weight log(SD) was -0.026 (95% confidence interval -0.044; 0.008), with greater variability in the placebo groups. Scatterplots did not show any slope divergence (i.e., interaction) between clinical predictors and the respective treatment (verum or placebo).

CONCLUSIONS:

We found no major treatment response heterogeneity in RCTs of glucose-lowering drugs for body weight reduction in type 2 diabetes. The precision medicine approach may thus be of limited value in this setting.

• Authors: Kris G Vargas, Tobias Rütten, Benedikt Siemes, Maximilian Brockmeyer, Claudio Parco, Alexander Hoss, Sabrina Schlesinger, Christian Jung, Michael Roden, Malte Kelm, Georg Wolff, Oliver Kuss
• Journal: Diabetes, obesity & metabolism (Diabetes Obes Metab) Vol. 26 Issue 6 Pg. 2139-2146 (Jun 2024) ISSN: 1463-1326 [Electronic] England
• PMID: 38425176 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)
• Copyright: © 2024 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

Chemical References

• Hypoglycemic Agents
• Sodium-Glucose Transporter 2 Inhibitors
• Glucagon-Like Peptide-1 Receptor
• Thiazolidinediones

Topics

• Diabetes Mellitus, Type 2 (drug therapy)
• Humans
• Randomized Controlled Trials as Topic
• Precision Medicine (methods)
• Weight Loss (drug effects)
• Hypoglycemic Agents (therapeutic use)
• Sodium-Glucose Transporter 2 Inhibitors (therapeutic use)
• Regression Analysis
• Male
• Female
• Treatment Outcome
• Glucagon-Like Peptide-1 Receptor (agonists)
• Middle Aged
• Thiazolidinediones (therapeutic use)
• Obesity (drug therapy)