SynthesisAging clinical and experimental research2025

Comparative efficacy and safety of antidiabetic drugs for obese patients with knee osteoarthritis: a network meta-analysis of randomized controlled trials.

Guangyao Jiang, Xiangyu Yang, Guanghui Zhu, Tang Liu

Abstract readComparative StudySystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in Aging clinical and experimental research, 2025. The graph read 2 numbers from its abstract, feeding 1 cell of the map: it finds no clear difference in 1. Cited by 2 papers.

2numbers the graph read from it
1cell of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

← favours the treatmentfavours the comparator →
-0.740.920 · no effect
Incidence of serious adverse eventsliraglutide vs usual careno clear difference · obesityfeeds one cell of the map
Δ 0.09-0.74 to 0.92
In terms of safety, usual care exhibited the lowest risk of adverse events, with liraglutide (0.09, 95% CI - 0.74, 0.92) and semaglutide (0.21, 95% CI - 0.46, 0.88) also showing favorable safety profiles.
Incidence of serious adverse eventssemaglutide vs usual careno clear difference · obesityfeeds one cell of the map
Δ 0.21-0.46 to 0.88
In terms of safety, usual care exhibited the lowest risk of adverse events, with liraglutide (0.09, 95% CI - 0.74, 0.92) and semaglutide (0.21, 95% CI - 0.46, 0.88) also showing favorable safety profiles.

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

GLP-1 receptor agonists×adverse events & safety

InconclusiveOpen on the map →What to test next →

40 readable studies in this cell: 47 favour the treatment, 14 find no difference, 2 favour the comparator.

Belief with this paper
0.02contested · 1 family supports, 41 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT017204463,297 enrolled · 2013
Δ -0.66-0.80 to -0.52
NCT036893742,274 enrolled · 2018
Δ -0.29-0.38 to -0.20
NCT013360231,663 enrolled · 2011
Treatment contrast -0.64-0.75 to -0.53
NCT040178321,441 enrolled · 2019
Δ -0.20-0.30 to -0.10
NCT018365231,398 enrolled · 2013
Δ -0.20-0.32 to -0.07
NCT019301881,231 enrolled · 2013
Δ -1.06-1.21 to -0.91
NCT007344741,202 enrolled · 2008
Δ -0.71-0.87 to -0.55
NCT008389031,049 enrolled · 2009
Δ -0.91-1.16 to -0.65
NCT009606611,036 enrolled · 2009
Δ -0.04-0.18 to 0.11
NCT050350821,018 enrolled · 2021
Δ -0.24-0.44 to -0.04
NCT01064687978 enrolled · 2010
Δ -1.05-1.22 to -0.88
NCT01117350978 enrolled · 2010
Δ 2.54-3.88 to 8.93

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

4 authors.

Guangyao JiangDepartment of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Xiangyu YangThe School of Pediatrics, University of South China, Hengyang, 410007, Hunan, China.
Guanghui ZhuThe Affiliated Children'S Hospital of Xiangya Medical School, Hunan Provincial Key Laboratory of Pediatric Orthopedics, Central South University (Hunan Children'S Hospital), Changsha, Hunan, China. zgh5650@163.com.
Tang LiuDepartment of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China. liutang1204@csu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundObesity-related knee osteoarthritis (KOA) is a significant public health concern, affecting quality of life. Recent evidence suggests some antidiabetic drugs may help manage KOA in obese patients due to their anti-inflammatory and weight-reducing effects.

objectiveThis study aimed to compare the efficacy and safety of antidiabetic drugs for managing pain and adverse events in obese KOA patients through a network meta-analysis of randomized controlled trials (RCTs).

methodsA systematic search of multiple databases identified relevant RCTs on antidiabetic drugs for KOA. Treatment efficacy was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score improvement, and safety was evaluated based on the incidence of serious adverse events. The Surface Under the Cumulative Ranking Curve (SUCRA) scores were used to rank the treatments, and effect sizes were reported as mean differences (MD) with 95% confidence intervals (CI).

resultsA total of nine RCTs were included in the analysis. For pain relief, metformin demonstrated the largest effect size with a mean difference of - 1.13 (95% CI - 1.48, - 0.78) compared to usual care, followed by Metformin-Phosphatidylcholine (MFPH) (- 0.92, 95% CI - 1.70, - 0.13) and semaglutide (- 0.90, 95% CI - 1.48, - 0.32). In terms of safety, usual care exhibited the lowest risk of adverse events, with liraglutide (0.09, 95% CI - 0.74, 0.92) and semaglutide (0.21, 95% CI - 0.46, 0.88) also showing favorable safety profiles. The SUCRA rankings further supported these findings, with metformin ranking highest for efficacy (SUCRA: 86.8%) and usual care ranking highest for safety (SUCRA: 75.7%). However, these rankings should be interpreted alongside the effect sizes and clinical context to fully assess the trade-offs between efficacy and safety across interventions.

conclusionsMetformin and MFPH are promising for managing KOA pain in obese patients. Semaglutide offers a balanced efficacy and safety profile, while liraglutide may be a safe option for selected patients. Further research is needed to confirm these findings and assess long-term outcomes.

Indexed as

Hypoglycemic AgentsObesityOsteoarthritis, KneeHumansMetforminRandomized Controlled Trials as TopicTreatment OutcomeHypoglycemic AgentsMetforminAntidiabetic drugsEfficacyKnee osteoarthritisMetforminNetwork meta-analysisObesitySafety

Identifiers

PMID40325308
PMCPMC12053337

What Socratic holds

Texttitle and abstract
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.