Treatment preference for once-weekly versus once-daily DPP-4 inhibitors in patients with type 2 diabetes mellitus - a systematic review and meta-analysis of randomized controlled trials

Sep 30, 2026

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Treatment preference differences between once-weekly and once-daily DPP-4 inhibitors remain clinically relevant despite increasing market adoption. This systematic review and meta-analysis synthesized randomized controlled trials comparing patient preferences and related outcomes in type 2 diabetes mellitus. Searches covered PubMed, OVID, EBSCO, Web of Science, CNKI, Wanfang, and trial registries through June 30, 2025. Eight RCTs (n=1,575) were analyzed.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages14

Reading Time35 min

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Abstract

Background/Objective

Methods

Results

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AnnAls of Medicine 2026, Vol. 58, no. 1, 2603036 [https://doi.org/10.1080/07853890.2025.2603036](https://doi.org/10.1080/07853890.2025.2603036) RESEARCH ARTICLE Treatment preference for once-weekly versus once-daily DPP-4 inhibitors in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials Xingxing Xiea,b , Yu Chena, Pei Wanga and Ming Hua aWest china school of Pharmacy, sichuan University, chengdu, sichuan Province, china; bdepartment of Pharmacy, Ya’an People’s Hospital, Ya’an, sichuan Province, china ABSTRACT Background/Objective: Although once-weekly and once-daily DPP-4 inhibitors have gained widespread market recognition, patient preference differences remain a key focus. This meta-analysis compares treatment preferences for once-weekly versus once-daily DPP-4 inhibitors in T2DM, offering evidence to guide clinical decisions and healthcare policies. Methods: PubMed, OVID, EBSCO, Web of Science, CNKI, Wanfang, and clinical trial registries were searched up to June 30, 2025. After screening literature against predefined criteria, a systematic review was conducted to compare the effects of once-weekly and once-daily DPP-4 inhibitors on the treatment preferences of patients with T2DM. Results: 8 RCTs with 1,575 participants were analyzed. No significant difference in medication adherence and DTSQ total score between the once-weekly and once-daily groups (p > 0.05). HbA1c percentage (MD = -0.21, 95% CI [-0.42, -0.01], p < 0.05) decreased significantly with once-weekly dosing, while GA and FPG showed no change (p > 0.05), this suggests greater improvement in HbA1c percentage levels following aswitch to once-weekly DPP-4 inhibitors. Once-weekly DPP-4 inhibitors showed higher musculoskeletal/connective tissue disorder risk (RR = 2.63; 95% CI [1. 18, 5.83]), but no significant differences in other adverse events (p > 0.05). No significant differences in treatment burden between both groups (p > 0.05). Conclusion: No statistically significant association between treatment preferences for once-weekly versus once-daily DPP-4 inhibitors among T2DM patients and medication adherence, treatment satisfaction, glycemic level changes, safety, or treatment burden for these two dosing regimens. Further research is needed to elucidate the influence of physician prescribing behavior on these preferences. Introduction ARTICLE HISTORY Received 26 August 2025 Accepted 5 December 2025 KEYWORDS Type 2 diabetes mellitus; treatment preference; once-weekly DPP-4 inhibitors; once-daily DPP-4 inhibitors; randomized controlled trials; systematic review Type 2 diabetes mellitus (T2DM) is the most prevalent diabetes subtype worldwide [1], and it constitutes a major 21st-century public health challenge [2] . Between 1990 and 2021, the global incidence of T2DM increased from 56.02 to 123.86 cases per 100,000 population—approximately a 1.5-fold rise [3] . By 2045, global prevalence is projected to reach 12.2%(783.2 million adults) [4], predominantly driven by increases in developing countries, with prevalence peaking at 13.1%[4,5] . T2DM pathogenesis is complex, encompassing insulin resistance [6], β-cell dysfunction, chronic inflammation, endoplasmic reticulum stress, and oxidative stress [7,8] . Current T2DM prevention and treatment strategies emphasize lifestyle modification, pharmacotherapy, and surgical treatment [9] . Among these, comprehensive management is essential to improve patient quality of life and mitigate complications [10, 11] . When lifestyle modifications fail to achieve glycemic control, pharmacotherapy becomes necessary, encompassing metformin, sulfonylureas, glinides, CONTACT Ming Hu [huming@scu.edu.cn](huming@scu.edu.cn) West china school of Pharmacy, sichuan University, chengdu, sichuan Province, china supplemental data for this article can be accessed online at [https://doi.org/10.1080/07853890.2025.2603036](https://doi.org/10.1080/07853

FAQs

How does once-weekly dosing compare with once-daily dosing for medication adherence and treatment satisfaction?

No significant difference was found between once-weekly and once-daily groups for medication adherence and the DTSQ total score (p > 0.05).

What glycemic outcomes differ between once-weekly and once-daily DPP-4 inhibitors?

HbA1c decreased significantly with once-weekly dosing (MD = -0.21, 95% CI [-0.42, -0.01], p < 0.05), while GA and FPG showed no significant change (p > 0.05).

Are there safety differences between the two dosing schedules?

Musculoskeletal/connective tissue disorders were higher with once-weekly inhibitors (RR = 2.63; 95% CI [1.18, 5.83]), while other adverse events did not differ significantly (p > 0.05).

What is the overall conclusion regarding treatment preference and related outcomes?

No statistically significant association was observed between treatment preference for once-weekly versus once-daily DPP-4 inhibitors and adherence, satisfaction, glycemic changes, safety, or treatment burden; further research is recommended to clarify physician prescribing influences.

Sep 30, 2026

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