Effect of glucagon‐like peptide‐1 receptor agonists on body weight in adults with obesity without diabetes mellitus—a systematic review and meta‐analysis of randomized control trials

Abstract

Summary Clinical trials have investigated the weight loss effect of glucagon‐like peptide‐1 receptor agonists (GLP‐1 RA) in adults with obesity without diabetes mellitus, but results for weight loss efficacy were varied. We aimed to provide an up‐to‐date systematic review and meta‐analysis for overall weight loss effect of GLP‐1 RA in adults with obesity and overweight without diabetes mellitus. We retrieved eligible randomized control trials that assessed the weight loss effect of GLP‐1 RA in adults (≥18 years old) without type 1/type 2 diabetes up to September 30, 2021, using Pubmed and Embase. Of 36 clinical trials assessed for eligibility, 12 trials were included, with a combined total of 11,459 participants. Compared with control groups, a more significant weight loss was seen in GLP‐1 RA groups with an overall mean difference of −7.1 kg (95% CI −9.2 to −5.0) (I2 = 99%). The overall analysis results showed that GLP‐1 RA improved glycemic control without increasing the risk of hypoglycemic events. Better control of blood pressure and plasma levels of LDL, HDL, and triglycerides was seen with GLP‐1 RA treatment. Subgroup analysis showed greater treatment effect of semaglutide than liraglutide. Vomiting, nausea, dyspepsia, diarrhea, constipation, and abdominal pain were GLP‐1 RA‐associated common adverse effects.

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

“…The conducted RCTs, 20,24–29 meta‐analyses (MAs), 11,12 and NMAs 10,30 have demonstrated the superiority of GLP‐1 RAs compared with placebo when evaluated for weight loss; thus, this factor will not be the central point of our discussion. In terms of the comparison between semaglutide and liraglutide, our findings support the previously reported results from the head‐to‐head comparison of these GLP‐1 RAs, 26,29 and they are also consistent with results from MAs 11 and NMAs 10,30 that compared GLP‐1 RAs alone or with other medication classes for the management of obesity in patients with or without diabetes. In particular, MAs conducted by Iqbal et al and Shi et al compared the efficacy of semaglutide to liraglutide for weight loss in adult patients without diabetes.…”

Efficacy and safety of semaglutide on weight loss in obese or overweight patients without diabetes: A systematic review and meta-analysis of randomized controlled trials

“… Vosoughi et al (2021) and He et al (2022) both explored the weight loss effect of once-weekly semaglutide for obesity, involving patients with or without diabetes. Iqbal et al (2022) and Zhong et al (2022) designed the study in non-diabetic patients intriguingly, but only contained three or four RCTs about semaglutide and placebo. Additionally, all the aforementioned studies focused on 2.4 mg-dosed semaglutide and placebo.…”

Which is the optimal antiobesity agent for patients with nonalcoholic fatty liver disease?

“…Semaglutide is a novel GLP-1 receptor agonist that appears to induce greater weight loss than liraglutide and has the additional advantage that it is administered once weekly, which might improve adherence to treatment (31). Moreover, the pharmacokinetic characteristics of semaglutide are not affected in patients with cirrhosis attributable to parenchymal liver disease, including NAFLD (32).…”