American Diabetes Association
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Efficacy of GLP-1 receptor agonists on weight loss, body mass index and waist circumference for obese or overweight patients: A systematic review, meta-analysis and meta-regression of 47 randomized-controlled trials

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posted on 2025-01-22, 20:23 authored by Hon Jen Wong, Bryan Sim, Yao Hao Teo, Yao Neng Teo, Mark Y Chan, Leonard LL Yeo, Pei Chia Eng, Benjamin YQ Tan, Naveed Sattar, Mayank Dalakoti, Ching-Hui Sia

Background

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have advanced rapidly in recent years.

Purpose

An updated synthesis on effects of GLP-1RAs on weight, BMI and waist circumference incorporating newer RCTs, particularly in overweight or obese patients, is timely.

Data Sources

We systematically searched PubMed, EMBASE and CENTRAL for RCTs published from inception to Oct 4, 2024.

Study Selection

The search was limited to RCTs evaluating the use of GLP1-RAs for mean differences from baseline in weight, BMI and waist circumference in obese or overweight adult patients with or without diabetes mellitus.

Data Extraction

Two independent reviewers performed the literature search and data extraction, resolving disagreements via consensus or third reviewer consultation.

Data Synthesis

47 RCTs were included with a combined cohort of 23,244 patients. GLP-1RAs demonstrated a mean weight reduction of -4.57 kg (95% CI -5.35 to -3.78), mean BMI reduction of -2.07 kg/m2 (95% CI -2.53 to -1.62), and mean waist circumference reduction of -4.55 cm (95% CI -5.72 to -3.38) compared to placebo. This effect was consistent across diabetic status, GLP-1RA used and route of administration. The greatest treatment benefit appeared to favour patients who were younger, female, non-diabetic, with higher baseline weight and BMI, but lower baseline HbA1c, and treated over a longer duration.

Limitations

Limitations include substantial statistical heterogeneity, in part due to broad inclusion criteria. However, this heterogeneity may improve generalizability by reflecting a wide range of study designs and patient populations.

Conclusions

GLP-1RAs demonstrated significant weight, BMI, and waist circumference reduction benefits in this meta-analysis.

Funding

CS has received writing support from Novartis.

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