Values, preferences, and treatment burden for initiation of GLP-1 receptor agonists, SGLT-2 inhibitors, tirzepatide, and finerenone in adults with type 2 diabetes: systematic review.

Systematic review of quantitative and qualitative studies on patient values and preferences

“DesignSystematic review.”

Adults with type 2 diabetes

“Eligibility criteriaQuantitative or qualitative studies were included if they reported patient reported values, preferences, or treatment burden among adults with type 2 diabetes and compared initiation of GLP-1 RA, SGLT-2i, tirzepatide, or finerenone with each other or with other glucose-lowering treatments.”

34 studies involving 15,656 patients

“Thirty four studies (15 656 patients) were included, 17 of which were new since the previous 2021 review (8360 patients).”

Literature search from database inception to 7 January 2025

“Medline, Embase, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials were searched from database inception to 7 January 2025 (updating a previous systematic review that captured literature up to 23 May 2020).”

Patients prioritized glycaemic efficacy, cardiovascular risk reduction, and simplicity of administration

“Across comparisons, patients consistently reported glycaemic efficacy, cardiovascular risk reduction, and simplicity of administration as their priorities.”

No consistent preference emerged between SGLT-2i and GLP-1 RA

“SGLT-2i and GLP-1 RA were often preferred over dipeptidyl peptidase 4-inhibitors (DPP-4i), thiazolidinediones, and insulins, but no consistent preference emerged for SGLT-2i over GLP-1 RA.”

Certainty of evidence for all comparisons was low or very low

“Certainty of evidence for all comparisons was low or very low certainty.”

Most included studies were observational and at high risk of bias, with low or very low certainty of evidence

“Most included studies were observational and at high risk of bias, and certainty of evidence for all comparisons was low or very low.”