Table 1.
Australian guideline | The US guideline | Chinese guideline | EU guideline | UK guideline | |
---|---|---|---|---|---|
Approved GLP-1 RA use | Exenatide Dulaglutide Liraglutide Semaglutide |
Exenatide Dulaglutide Liraglutide Semaglutide Lixisenatide |
Exenatide Dulaglutide Liraglutide Semaglutide Loxenatide Benaglutide |
Exenatide Dulaglutide Liraglutide Semaglutide |
Exenatide Lixisenatide Dulaglutide Liraglutide Semaglutide |
| |||||
Recommendations | Second line agent after metformin in T2DM patients | Fourth line as add on to metformin and SU therapy if BMI > 35 or significant issues with insulin use | |||
First line in T2DM with CVD risk, CKD without albuminuria Obesity/overweight without diabetes |
First line in T2DM with CVD risk, CKD without albuminuria, and obesity/overweight Not for obesity and overweight without diabetes |
First line agent in T2DM with established or high risk of CVD | |||
| |||||
Concerns | GI side effects are common, increased risk of hypoglycaemia with metformin or SU therapy, pancreatitis, and gall bladder disease | GI side effects are common, injection site reactions, pancreatitis, FDA black box—risk of thyroid C-cell tumours in rodents, and human relevance not determined | Contraindicated for use in pregnant or lactating women, patients with severe gastrointestinal disease, a history or high risk of pancreatitis, and not for eGFR < 30 ml/min | GI side effects are common, less effective than SGLT2i at reducing HF hospitalisations | GI side effects are common, not cost effective as first line therapy |
SU: sulphonylurea.