was associated with lower weight, BMI, waist circumference, and HbA1c in people with antipsychotic-associated weight gain, with vomiting reported more often.
Evidence
This systematic review and meta-analysis pooled nine studies with 44,233 participants evaluating semaglutide for antipsychotic-induced weight gain in schizophrenia, bipolar disorder, and other psychiatric diseases.
Caveat
The pooled weight, BMI, and HbA1c estimates had very high heterogeneity, and the abstract notes that semaglutide's role in has been evaluated in only few studies.
Simplified
(AIWG) is a difficult-to-manage condition. is a widely used weight-lowering agent, but its role in AIWG has been evaluated in only few studies. This SRM evaluated if semaglutide can be effectively and safely used for AIWG in schizophrenia, bipolar disorder, and other psychiatric diseases. Electronic databases were searched for articles evaluating the use of semaglutide for managing AIWG. The primary outcome was reduction in body weight. Secondary outcomes were changes in body mass index (BMI), waist circumference (WC), HBA1c, metabolic parameters, and adverse events. Data from nine studies (44,233 participants; 4.21% diabetes; 94.79% euglycemia) which fulfilled all criteria were analysed. Semaglutide for AIWG was associated with a significant reduction in weight [mean difference (MD) -7.37 kg (95% confidence interval (CI): -12.39, -2.35);< 0.001; I= 99%], BMI [MD -2.76 kg/m(95% CI: -4.15, -1.37);< 0.001; I= 98%], WC [MD -5.12 cm (95% CI: -7.21, -3.03);< 0.001; I= 76%], HbA1c [MD -0.35% (95% CI: -0.47, -0.24);< 0.001; I= 91%] and higher >5% weight loss [OR 2.25 (95% CI: 2.14, 2.36);< 0.001; I= 0%]. The occurrence of nausea, diarrhoea, and injection site reactions was similar. Vomiting was significantly higher in semaglutide users. The occurrence of psychiatric adverse events was lower in semaglutide users but not significant [OR 0.59 (95% CI: 0.33-1.07);= 0.08; I= 0%]. Semaglutide has good efficacy data with regard to quantum of weight loss with good safety for managing AIWG. P P P P P P2 2 2 2 2 2 2
Key numbers
-7.37 kg
Weight Reduction
Mean difference in body weight compared to controls.
-2.76 kg/m²
BMI Reduction
Mean difference in body mass index compared to controls.
-5.12 cm
Waist Circumference Reduction
Mean difference in waist circumference compared to controls.
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