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Compound monograph · evidence extract

Mazdutide in type 2 diabetes mellitus — evidence extract

The Institute's graded assessment of Mazdutide for type 2 diabetes mellitus, with the contributing trials and the domain-by-domain certainty reasoning.

Document identifier
CEI-MN-014/EV-T2DM
Series
Evidence extract
Version
3.1
Published
22 Feb 2025
Last reviewed
22 Jun 2026
Next review
22 Jun 2028
Identifier
10.71829/cei.mono.14
Certainty
Moderate
Cycle
2025 Q1

§1Evidence extract: Type 2 diabetes mellitus

§1.1Question and anchor outcome

Population
A disorder of glucose regulation characterised by insulin resistance with relative insulin deficiency, diagnosed by glycated haemoglobin, fasting plasma glucose or oral glucose tolerance criteria.
Intervention
Mazdutide, subcutaneous once weekly
Comparator
As used in each contributing trial; reported per trial rather than pooled across comparator types
Anchor outcome
Change in HbA1c (%, mmol/mol)

Additional outcomes the Institute extracts for this indication: Proportion achieving HbA1c <7.0 % and ≤6.5 %; Change in fasting serum glucose; Change in body weight; Documented symptomatic hypoglycaemia.

§1.2Contributing trials

Table 1. Trials contributing to the assessment of Mazdutide in type 2 diabetes mellitus.

TrialPhaseDesignRandomisedDurationYear
DREAMS-23Randomised, double-blind, placebo-controlled73148 weeks2024
DREAMS-33Randomised, double-blind, active-controlled52 weeks

§1.3Certainty assessment

Certainty assessment by domainDowngrading decision recorded for each certainty domain.Certainty domainNo concernSeriousVery seriousEffect on ratingRisk of biasno downgradeInconsistencydowngrade one levelIndirectnessno downgradeImprecisionno downgradePublication biasno downgradeTotal downgrading: 1 levelModerate certainty
Figure 2. Domain-by-domain certainty assessment for Mazdutide in type 2 diabetes mellitus. The starting rating for a body of randomised evidence is high; each serious concern reduces it by one level and each very serious concern by two.

Table 2. Reasoning recorded against each certainty domain.

DomainRatingReasoning
Risk of biasNo concernNo serious concern identified in this domain.
InconsistencySeriousDirection is consistent; magnitude varies with the intensity of the background intervention.
IndirectnessNo concernNo serious concern identified in this domain.
ImprecisionNo concernNo serious concern identified in this domain.
Publication biasNo concernNo serious concern identified in this domain.
Overall rating: Moderate certainty. The true effect is likely to be close to the estimate, but there is a possibility that it is substantially different. Further research is likely to have an important impact on confidence in the estimate.

§1.4What this extract does not establish

References cited on this page

References are numbered in order of first citation in this document. Each superscript in the text links to its entry below.

  1. Ji L, Jiang H, Bi Y, Li X, Ning G, Qu S, Wu Y, Yang J, Chen L, Li L, Zhang M, Qian L. Efficacy and safety of mazdutide in Chinese participants with overweight or obesity: a randomised, double-blind, placebo-controlled phase 2 trial. Diabetes, Obesity and Metabolism 2023;25(12):3691–3700. doi:10.1111/dom.15264
  2. Müller TD, Finan B, Bloom SR, D’Alessio D, Drucker DJ, Flatt PR, Fritsche A, Gribble F, Grill HJ, Habener JF, Holst JJ, Langhans W, Meier JJ, Nauck MA, Perez-Tilve D, Pocai A, Reimann F, Sandoval DA, Schwartz TW, Seeley RJ. Glucagon-like peptide 1 (GLP-1). Molecular Metabolism 2019;30:72–130. doi:10.1016/j.molmet.2019.09.010 · PMID 31767182
  3. le Roux CW, Steen O, Lucas KJ, Startseva E, Unseld A, Hennige AM. Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial. The Lancet Diabetes & Endocrinology 2024;12(3):162–173. doi:10.1016/S2213-8587(23)00356-X · PMID 38330977

Identifiers are reproduced only where the Institute holds them. Where a digital object identifier or PubMed identifier is not shown, the Institute has recorded the journal and year and has not constructed an identifier.

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