The Antiobesity Effect and Safety of GLP-1 Receptor Agonist in Overweight/Obese Patients Without Diabetes: A Systematic Review and Meta-Analysis

May 5, 2022Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme

Weight loss effects and safety of GLP-1 receptor drugs in overweight or obese people without diabetes

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Abstract

Treatment with glucagon-like peptide-1 receptor agonists (GLP-1RAs) resulted in a weighted mean difference of -5.39 kg in weight loss compared to placebo.

GLP-1RAs, including liraglutide, exenatide, and semaglutide, significantly promoted weight loss in overweight/obese patients without diabetes.
Semaglutide showed the most substantial effects on weight loss, body mass index (BMI), and waist circumference (WC).
Patients treated with GLP-1RAs experienced more gastrointestinal side effects, such as nausea and vomiting, compared to those receiving placebo and metformin.
Among the GLP-1RAs, semaglutide had the lowest risk of gastrointestinal adverse events.

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Aim To determine the antiobesity effect and safety of glucagon-like peptide-1 receptor agonist (GLP-1RA) including liraglutide, exenatide and semaglutide treatment in overweight/obese patients without diabetes. The random-effect model was used to pool data extracted from included literatures. The weighted mean difference (WMD), odds ratio and 95% confidence interval (CI) were used to present the meta-analysis results (PROSPERO registration number: CRD 42020173199). The sources of intertrial heterogeneity, bias and the robustness of results were evaluated by subgroup analysis, sensitivity analysis and regression analysis, respectively. A total of 24 RCTs were recruited in the present analysis which included 5867 patients. The results showed that the treatment of overweight/obese patients without diabetes with GLP-1RAs including liraglutide, exenatide and semaglutide significantly achieved greater weight loss than placebo [WMD=-5.39, 95% CI (-6.82, -3.96)] and metformin [WMD=-5.46, 95% CI (-5.87, -5.05)]. The subgroup analysis showed that semaglutide displayed the most obvious antiobesity effect in terms of weight loss, the reduction of body mass index (BMI) and waist circumference (WC). However, GLP-1RAs treatments had more gastrointestinal adverse events (such as nausea and vomiting) than placebo and Met. The subgroup analysis also represented that semaglutide displayed the lowest risk of gastrointestinal adverse events among three kinds of GLP-1RAs. Our meta-analysis demonstrated that GLP-1RA had a superior antiobesity effect than placebo/Met in overweight/obese patients without diabetes in terms of body weight, BMI, and WC, especially for semaglutide, which had more obvious antiobesity effect and lower GI adverse events than liraglutide and exenatide.

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The Antiobesity Effect and Safety of GLP-1 Receptor Agonist in Overweight/Obese Patients Without Diabetes: A Systematic Review and Meta-Analysis

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