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What is already known on this topic Glucagon-like peptide-1 receptor agonist (GLP-1RA) is a promising drug class that has shown benefits for adults with type 2 diabetes Regulatory authorities have approved several GLP-1RA drugs, and novel drugs are continually emerging, resulting in an urgent need for updated evidence synthesis of the comparative effectiveness of various GLP-1RAs What this study adds Compared with the placebo, all 15 GLP-1RAs had significant effects on glycaemic control, and tirzepatide was the most effective in reducing haemoglobin A 1c and fasting plasma glucose concentrations CagriSema induced the highest weight reduction in adults with type 2 diabetes, followed by tirzepatide and retatrutide Several GLP-1RAs resulted in a significantly higher odds ratio of discontinuation due to adverse events than placebo, raising safety concerns about gastrointestinal adverse events, especially at high doses Ethics statements Ethical approval Not required
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