Efficacy and safety of mazdutide vs. dulaglutide in adults with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials.
- 1Dow University of Health Sciences, Karachi, Pakistan.
- 2Faculty of Medicine, Kabul University of Medical Sciences "Abu Ali Ibn Sina", Kabul, Afghanistan. [email protected].
Abstract
Background
Type 2 diabetes mellitus (T2DM) is closely linked to obesity and carries a high risk of metabolic complications. While GLP-1 receptor agonists like dulaglutide improve blood sugar and support modest weight loss, many patients do not reach their treatment goals. Mazdutide, a dual GLP-1 and glucagon receptor agonist, may offer stronger metabolic benefits.Objective
To compare the efficacy and safety of mazdutide versus dulaglutide in adults with T2DM.Methods
We systematically reviewed randomized controlled trials comparing mazdutide and dulaglutide. Primary outcomes included changes in HbA1c, body weight, and achievement of glycemic and weight-loss targets. Safety outcomes included treatment-emergent adverse events. Data were pooled using random-effects models, and evidence certainty was assessed using GRADE.Results
Three trials met inclusion criteria. Mazdutide led to greater reductions in HbA1c (- 0.25%) and body weight (- 2.97 kg) compared with dulaglutide. Patients were more likely to achieve HbA1c < 7.0%, ≥ 5% weight loss, and the combined target of ≥ 5% weight loss with HbA1c < 7.0%. Fasting plasma glucose was numerically but not significantly improved. Mazdutide was associated with higher rates of gastrointestinal side effects and decreased appetite, with a non-significant numerical increase in hypoglycemia, while serious adverse events and discontinuations were similar between treatments. Glycemic and major weight outcomes were supported by high-certainty evidence; most safety outcomes were moderate-certainty.Conclusions
Mazdutide, based on evidence from three RCTs, provides preliminary evidence of meaningful improvements in blood sugar control and weight loss compared with dulaglutide, though with an increased risk of mostly manageable gastrointestinal effects; given the limited number of trials, these findings should be considered preliminary and supporting its potential role as a promising dual-action therapy for T2DM management, pending confirmation in larger, longer-term trials.
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BibTeX
@article{hassan2026efficacy,
title = {{Efficacy and safety of mazdutide vs. dulaglutide in adults with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials.}},
author = {Muhammad Hassan and Muhammad Hussain and Saifullah Khan and Muhammad Tayyab Azam and Zain Ul Abideen Shahid and Abdul Hannan and Muhammad Mussawir Khuhro and Sahil Bhagia and Hasibullah Aminpoor},
journal = {Diabetology \& metabolic syndrome},
year = {2026},
month = jul,
doi = {10.1186/s13098-026-02248-3},
url = {https://europepmc.org/article/MED/42897592},
note = {CC BY},
}
RIS
TY - JOUR
TI - Efficacy and safety of mazdutide vs. dulaglutide in adults with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials.
AU - Muhammad Hassan
AU - Muhammad Hussain
AU - Saifullah Khan
AU - Muhammad Tayyab Azam
AU - Zain Ul Abideen Shahid
AU - Abdul Hannan
AU - Muhammad Mussawir Khuhro
AU - Sahil Bhagia
AU - Hasibullah Aminpoor
PY - 2026
DA - 2026/07/01
JO - Diabetology & metabolic syndrome
DO - 10.1186/s13098-026-02248-3
UR - https://europepmc.org/article/MED/42897592
AB - Background Type 2 diabetes mellitus (T2DM) is closely linked to obesity and carries a high risk of metabolic complications. While GLP-1 receptor agonists like dulaglutide improve blood sugar and support modest weight loss, many patients do not reach their treatment goals. Mazdutide, a dual GLP-1 and glucagon receptor agonist, may offer stronger metabolic benefits.Objective To compare the efficacy and safety of mazdutide versus dulaglutide in adults with T2DM.Methods We systematically reviewed randomized controlled trials comparing mazdutide and dulaglutide. Primary outcomes included changes in HbA1c, body weight, and achievement of glycemic and weight-loss targets. Safety outcomes included treatment-emergent adverse events. Data were pooled using random-effects models, and evidence certainty was assessed using GRADE.Results Three trials met inclusion criteria. Mazdutide led to greater reductions in HbA1c (- 0.25%) and body weight (- 2.97 kg) compared with dulaglutide. Patients were more likely to achieve HbA1c < 7.0%, ≥ 5% weight loss, and the combined target of ≥ 5% weight loss with HbA1c < 7.0%. Fasting plasma glucose was numerically but not significantly improved. Mazdutide was associated with higher rates of gastrointestinal side effects and decreased appetite, with a non-significant numerical increase in hypoglycemia, while serious adverse events and discontinuations were similar between treatments. Glycemic and major weight outcomes were supported by high-certainty evidence; most safety outcomes were moderate-certainty.Conclusions Mazdutide, based on evidence from three RCTs, provides preliminary evidence of meaningful improvements in blood sugar control and weight loss compared with dulaglutide, though with an increased risk of mostly manageable gastrointestinal effects; given the limited number of trials, these findings should be considered preliminary and supporting its potential role as a promising dual-action therapy for T2DM management, pending confirmation in larger, longer-term trials.
SN - 1758-5996
ER -