Comparative effectiveness of glucagon‐like peptide‐1 receptor agonists for the management of obesity in adults without diabetes: A network meta‐analysis of randomized clinical trials

Dec 29, 2022Obesity reviews : an official journal of the International Association for the Study of Obesity

Comparing the effectiveness of GLP-1 drugs for treating obesity in adults without diabetes

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Abstract

Over 12,300 patients were included in the analysis of tirzepatide's efficacy for weight loss.

Weekly tirzepatide 10 and 15 mg resulted in greater weight loss compared to weekly semaglutide 2.4 mg, daily semaglutide 0.4 mg, or liraglutide 3 mg.
Tirzepatide and weekly semaglutide showed similar efficacy, but tirzepatide had significantly higher odds of achieving ≥5%-20% weight loss compared to liraglutide.
More gastrointestinal adverse events were reported with GLP-1 receptor agonists compared to placebo, with no significant difference between the drugs.
All GLP-1 receptor agonists evaluated resulted in significant weight reduction, with tirzepatide showing better efficacy outcomes.

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Tirzepatide is a new glucagon-like peptide-1 receptor agonist (GLP-1RA) that has shown promising results for weight loss. A Bayesian network meta-analysis was conducted to compare the efficacy and safety of GLP-1RAs for obesity management. Embase and MEDLINE were searched looking for randomized clinical trials (RCTs) that evaluated the efficacy of GLP-1RAs for weight loss in patients without diabetes. The main efficacy outcomes evaluated were the mean change in actual and percentage weight loss and the proportion of patients with weight loss of ≥5%-20%. Main safety outcomes evaluated include nausea, vomiting, diarrhea, constipation, loss of appetite, pancreatitis, gallbladder-related disorders, and withdrawal due to adverse events. Seven RCTs with more than 12,300 patients were analyzed, including patients with body mass index (BMI) ≥ 30 kg/m, or BMI ≥ 27 kg/mwith comorbidities. Weekly tirzepatide 10 and 15 mg resulted in more weight loss than weekly semaglutide 2.4 mg, daily semaglutide 0.4 mg, or liraglutide 3 mg. Tirzepatide and weekly semaglutide demonstrated comparable results but with significantly higher odds of achieving ≥5%-20% weight loss compared with liraglutide. GLP-1RAs triggered more gastrointestinal adverse events than placebo, with no in-between difference. Although all GLP-1RAs lead to significant weight reduction, tirzepatide was associated with better efficacy outcomes while having a comparable safety profile. 2 2

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Comparative effectiveness of glucagon‐like peptide‐1 receptor agonists for the management of obesity in adults without diabetes: A network meta‐analysis of randomized clinical trials

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