OBJECTIVE: To evaluate the efficacy

safety and adverse drug reactions of semaglutide in the treatment of type 2 diabetes mellitus. METHODS: CNKI

CBM

Wanfang Data

VIP

PubMed

Embase

the Cochrance Library

Web of science and ClinicalTrials.gov databases were retrieved to collect the randomized controlled trial（RCT） of semaglutide versus placebo in the treatment of type 2 diabetes mellitus. Evaluation of the quality of included literature and extraction of data were performed. Meta-analysis was performed by using Stata 16 and RevMan 5.3 software. RESULTS: A total of 11 RCT were enrolled

including 5 753 patients. Compared with placebo

semaglutide had significant effect on hypoglycemic and weight loss

and could reduce the glycosylated hemoglobin（HbA

1

c） level（MD=-1.18

95%CI=-1.35--1.02

P

<

0.000 1）

fasting blood glucose level（MD=-1.65

95%CI=-1.95--1.36

P

<

0.000 1） and body weight（MD=-3.06

95%CI=-3.94--2.19

P

<

0.000 01）

significantly increase the HbA

1

c compliance rate（control rate of HbA

1

c

<

6.5%:RR=5.57

95%CI=4.06-7.63

P

<

0.000 01;control rate of HbA

1

c

<

7.0%:RR=3.55

95%CI=2.88-4.36

P

<

0.000 01）

decrease the systolic blood pressure（MD=-3.16

95%CI=-4.30--2.02

P

<

0.000 01） in patients with type 2 diabetes mellitus

the differences were statistically significant. Compared with placebo

semaglutide had slightly higher incidence of adverse events（RR=1.09

95%CI=1.05-1.13

P

<

0.000 1）

of which gastrointestinal reactions were the most common（RR=1.95

95%CI=1.73-2.20

P

<

0.000 01）. However

the incidence of severe adverse events（RR=0.98

95%CI=0.80-1.20

P=0.83） and hypoglycemia（RD=-0.00

95%CI=-0.03-0.02

P=0.78） were similar to those of placebo. CONCLUSIONS: Compared with placebo

semaglutide has significant hypoglycemic and weight loss effect. Semaglutide has a lower risk of hypoglycemia. Gastrointestinal reactions are the main adverse drug reactions of semaglutide

yet the symptoms are generally mild.