COMPARATIVE EFFECTIVENESS OF COMPLETE REGIMEN NODES FOR CHINESE INJECTABLE GLP-1-CLASS WEIGHT-LOSS THERAPIES: NETWORK META-ANALYSIS WITH TIME-ANCHORED VALIDATION
Author(s)
Chunlu Wang, Doctor Candidate.
Center for Health Insurance & Health Services Research, University of International Business and Economics, Beijing, China.
Center for Health Insurance & Health Services Research, University of International Business and Economics, Beijing, China.
OBJECTIVES: Seven injectable GLP-1-class products have Chinese registrational weight-management trials with primary endpoints at 12-48 weeks and heterogeneous doses and schedules. Percent weight-change estimates are not rankable without complete regimen definitions (drug, dose, frequency, endpoint week). We compared all fourteen placebo-controlled nodes, characterised dose-response and phase 3 benefit-risk, and generated comparative-effectiveness evidence for formulary and health technology assessment.
METHODS: Published aggregate data from Chinese phase 2/3 trials reporting percent weight change versus placebo with standard errors were synthesised. Each NMA node was one complete regimen; dose and frequency defined arms, not regression covariates. Analyses: random-effects meta-analysis, meta-regression (baseline BMI, female proportion, phase), frequentist and Bayesian NMA, phase 3 benefit-risk composites, and digitisation of 136 on-treatment timepoints at shared visit weeks 4-48.
RESULTS: Fourteen nodes from seven products formed a star network (k=14). Pooled effect was −11.0% (95% CI −13.1 to −8.9; I²≈93%); primary endpoint estimates ranged from −3.6% (beinaglutide, week 16) to −18.5% (GZR18 30 mg once weekly, week 35). NMA ranked GZR18 30 mg once weekly highest, then HRS9531 6 mg (−16.3%), HRS9531 4 mg (−15.0%), mazdutide 6 mg (−14.3%), GZR18 30 mg every two weeks (−14.2%), and ecnoglutide 2.4 mg (−13.3% at week 40). Semaglutide at week 44 was −8.5%. Dose-response was monotonic within ecnoglutide, mazdutide, and HRS9531 trials; GZR18 once-weekly exceeded every-two-week dosing by 4.3 percentage points at week 35. Meta-regression showed no independent predictors (all p>0.57). Phase 3 benefit-risk favoured HRS9531 2 mg (efficacy −9.3%; nausea 16%) over mazdutide 6 mg (nausea 51%). Semaglutide subgroups: type 2 diabetes −5.9% versus −9.4% without diabetes. Week-48 time-anchored rankings matched endpoint NMA.
CONCLUSIONS: Full-regimen NMA maps China's GLP-1 weight-loss pipeline for payers and guideline panels. Endpoint-stratified formulary evaluation is preferable to drug-level labels; administration frequency defines distinct regimen nodes. Time-anchored curves supplement—but do not replace—endpoint-based indirect comparison when follow-up weeks differ.
METHODS: Published aggregate data from Chinese phase 2/3 trials reporting percent weight change versus placebo with standard errors were synthesised. Each NMA node was one complete regimen; dose and frequency defined arms, not regression covariates. Analyses: random-effects meta-analysis, meta-regression (baseline BMI, female proportion, phase), frequentist and Bayesian NMA, phase 3 benefit-risk composites, and digitisation of 136 on-treatment timepoints at shared visit weeks 4-48.
RESULTS: Fourteen nodes from seven products formed a star network (k=14). Pooled effect was −11.0% (95% CI −13.1 to −8.9; I²≈93%); primary endpoint estimates ranged from −3.6% (beinaglutide, week 16) to −18.5% (GZR18 30 mg once weekly, week 35). NMA ranked GZR18 30 mg once weekly highest, then HRS9531 6 mg (−16.3%), HRS9531 4 mg (−15.0%), mazdutide 6 mg (−14.3%), GZR18 30 mg every two weeks (−14.2%), and ecnoglutide 2.4 mg (−13.3% at week 40). Semaglutide at week 44 was −8.5%. Dose-response was monotonic within ecnoglutide, mazdutide, and HRS9531 trials; GZR18 once-weekly exceeded every-two-week dosing by 4.3 percentage points at week 35. Meta-regression showed no independent predictors (all p>0.57). Phase 3 benefit-risk favoured HRS9531 2 mg (efficacy −9.3%; nausea 16%) over mazdutide 6 mg (nausea 51%). Semaglutide subgroups: type 2 diabetes −5.9% versus −9.4% without diabetes. Week-48 time-anchored rankings matched endpoint NMA.
CONCLUSIONS: Full-regimen NMA maps China's GLP-1 weight-loss pipeline for payers and guideline panels. Endpoint-stratified formulary evaluation is preferable to drug-level labels; administration frequency defines distinct regimen nodes. Time-anchored curves supplement—but do not replace—endpoint-based indirect comparison when follow-up weeks differ.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
CO102
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment, Comparative Effectiveness or Efficacy
Disease
Biologics & Biosimilars, Diabetes/Endocrine/Metabolic Disorders (including obesity)