Network meta-analysis
HbA1c below 7 percent
Type 2 diabetes (adults); background therapy: no glucose lowering drug (lifestyle only)
weeks 36 to 64 (target week 52)Hypothetical (as if everyone stayed on treatment)Doses of a drug pooledOdds ratio
2
Randomized trials
3
Treatments
742
Participants
423
Events
In plain language
Across 2 trials with 742 participants, 1 of 2 treatments had a clearly better result than placebo on HbA1c below 7 percent, and for 1 the evidence could not tell it apart from placebo. The most favorable estimate was for Orforglipron tablet: odds ratio 6.06 (95% credible interval 1.15 to 19.50).
Higher values favor the treatment. "Clearly" means the 95% credible interval excludes no difference. These are averages across trials; they do not say how any one person will respond. Not medical advice.
Network of trials
Each circle is a treatment; each line joins treatments that were randomized against each other in at least one trial.
Effects compared with Placebo
Odds ratio. Higher values favor the treatment.
| Treatment | Bayesian OR (95% CrI) | 95% prediction interval | Frequentist OR (95% CI) | Verdict |
|---|---|---|---|---|
| Orforglipron tablet ORFO_PO | 6.06 (1.15 to 19.50) | 0.59 to 37.43 | 6.54 (4.02 to 10.64) | Better |
| Albiglutide injection ALBI_SC | 2.80 (0.62 to 9.48) | 0.36 to 18.29 | 2.96 (1.69 to 5.17) | Unclear |
Ranking
How likely each treatment is to be among the best. Rankings ignore the size of differences and their certainty, so read them with the effects above.
League table
Every treatment against every other: odds ratio of the row treatment versus the column treatment, posterior median and 95% credible interval. Green: row clearly better; red: row clearly worse.
| Row versus column | PLACEBO | ORFO_PO | ALBI_SC |
|---|---|---|---|
| PLACEBO | PLACEBO | 0.16 0.05 to 0.87 | 0.36 0.11 to 1.62 |
| ORFO_PO | 6.06 1.15 to 19.50 | ORFO_PO | 2.13 0.28 to 12.99 |
| ALBI_SC | 2.80 0.62 to 9.48 | 0.47 0.08 to 3.58 | ALBI_SC |
Heterogeneity, fit and convergence
Bayesian random effects (primary)
Frequentist check (netmeta)
Inconsistency
Do trials comparing two treatments directly agree with the indirect evidence through other treatments?
No comparison here has both direct and indirect evidence, so inconsistency cannot be checked by node splitting; the between designs Q above is the global check.
Small study effects
A comparison adjusted funnel plot: each point is one trial comparison, centered on its own network estimate. Asymmetry can signal that small trials with unfavorable results are missing.
Fewer than ten trial comparisons, too few to judge funnel plot asymmetry.
Baseline characteristics of the trials
The baseline value of each effect modifier or prognostic factor that applies here, per trial: mean or percent over arms, weighted by the number randomized. A note under a value names a stand in (a median for a mean, 100 minus the male share, Asian subgroup rows, an all Asian site list); "not reported" means no source of the trial prints it.
| Trial | Baseline HbA1c (percent) effect modifier, prognostic factor; 2 of 2 | Background glucose lowering therapy (stratum S0 to S4) effect modifier, prognostic factor; 2 of 2 | Diabetes duration (years) effect modifier, prognostic factor; 2 of 2 |
|---|---|---|---|
| NCT00849017 S000852 | 8.07 | S0 | 3.97 |
| ACHIEVE-1 S001950 | 7.98 | S0 | 4.4 |
Comparability of the trials
Checked across designs (the set of treatments each trial compares) for eligibility, outcome definition and assessment, and the baseline factors above. Flags point to possible intransitivity; notes describe variation that is not tied to design.
- FlagOutcome assessment, proportion method: confounded with design: not stated 1, not_stated 1
- NoteOutcome assessment, time point: selected time points span 40 to 52 weeks
- NoteData handling, input conversions: arms_combined 2, count_from_percent 2
| Trial | time weeks | analysis set | definition | instrument | adjudicated | proportion method | intercurrent events (discontinuation) | intercurrent events (rescue) | blinding | funding | start year | Eligibility |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NCT00849017 | 52 | modified_itt | not stated | not stated | not stated | not stated | hypothetical | hypothetical | double_blind | industry | 2009 | age 18 or older; HbA1c 7.0 to 10.0 percent; BMI 20 to 45; diet and exercise only |
| ACHIEVE-1 | 40 | modified_itt | not stated | not stated | not stated | not_stated | hypothetical | hypothetical | double_blind | industry | 2023 | adults with type 2 diabetes on diet and exercise alone; HbA1c 7.0 to 9.5 percent |
Trial data
What each trial contributes. Arm rows give the arm value with its standard error, or events over participants; contrast rows give the odds ratio on the analysis scale (log) against the trial's first row. Flags mark converted, combined or approximated inputs.
| Trial | Arm | Treatment | Week | Data | Value | SE | Events / N | Flags | Source |
|---|---|---|---|---|---|---|---|---|---|
| NCT00849017 | A1 | PLACEBO | 52 | arm, responders | 21 / 98 | registry:outcomes | |||
| NCT00849017 | A2+A3 | ALBI_SC | 52 | arm, responders | 88 / 197 | arms_combined | registry:outcomes | ||
| ACHIEVE-1 | A1 | PLACEBO | 40 | arm, responders | 36 / 97 | count_from_percent | registry:outcomes | ||
| ACHIEVE-1 | A2+A3+A4 | ORFO_PO | 40 | arm, responders | 278 / 350 | count_from_percent;arms_combined | registry:outcomes |
Rerun this analysis yourself
Remove treatments or trials and refit the frequentist and Bayesian models in your browser, with the same methods as the published analysis.