Barboza Joshuan J, Huamán Mariella R, Melgar Beatriz, Diaz-Arocutipa Carlos, Valenzuela-Rodriguez German, Hernandez Adrian V
Unidad de Revisiones Sistemáticas y Meta-Análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola (USIL), Lima 15024, Peru.
Tau Relaped Group, Trujillo 13007, Peru.
J Clin Med. 2022 May 25;11(11):2998. doi: 10.3390/jcm11112998.
Objective: We systematically assessed the efficacy of liraglutide in non-diabetic obese adults. Methods: Six databases were searched up to July 2021 for randomized controlled trials (RCTs) assessing liraglutide versus placebo in obese adults. Primary outcomes were body weight and body mass index (BMI). Secondary outcomes were treatment-emergent adverse events (TEAEs), hypoglycemic episodes, HbA1c, and blood pressure. Effect measures were risk ratio (RR) or mean difference (MD) with their confidence interval (95%CI). Random-effects models and inverse variance meta-analyses were used. Quality of evidence was assessed using GRADE. Results: Twelve RCTs (n = 8249) were included. In comparison to placebo, liraglutide reduced body weight (MD −3.35 kg; 95%CI −4.65 to −2.05; p < 0.0001), and BMI (MD −1.45 kg/m2; 95%CI −1.98 to −0.91; p < 0.0001). Liraglutide did not reduce TEAEs (RR 1.08; 95%CI 0.92 to 1.27; p = 0.25), and Hb1Ac (MD −0.76%; 95%CI −2.24 to 0.72; p = 0.31). Furthermore, it did not increase hypoglycemic episodes (RR 2.01; 95%CI 0.37 to 11.02; p = 0.28). Finally, liraglutide reduced systolic blood pressure (MD −3.07 mmHg; 95%CI −3.66 to −2.48; p < 0.0001) and diastolic blood pressure (MD −1.01 mmHg; 95%CI −1.55 to −0.47; p = 0.0003). Seven RCTs had a high risk of bias. Subgroup analyses by length of treatment and doses had effects similar to the overall analyses. Quality of evidence was low or very low for most outcomes. Conclusions: In non-diabetic obese adults, liraglutide reduced body weight, BMI and blood pressure in comparison to placebo. Adverse events, Hb1Ac levels and hypoglycemic episodes were not different than placebo.
我们系统评估了利拉鲁肽在非糖尿病肥胖成年人中的疗效。方法：检索截至2021年7月的六个数据库，查找评估利拉鲁肽与安慰剂在肥胖成年人中疗效的随机对照试验（RCT）。主要结局指标为体重和体重指数（BMI）。次要结局指标为治疗中出现的不良事件（TEAE）、低血糖发作、糖化血红蛋白（HbA1c）和血压。效应测量指标为风险比（RR）或均值差（MD）及其置信区间（95%CI）。采用随机效应模型和逆方差荟萃分析。使用GRADE评估证据质量。结果：纳入了12项RCT（n = 8249）。与安慰剂相比，利拉鲁肽降低了体重（MD −3.35 kg；95%CI −4.65至−2.05；p < 0.0001）和BMI（MD −1.45 kg/m²；95%CI −1.98至−0.91；p < 0.0001）。利拉鲁肽未降低TEAE（RR 1.08；95%CI 0.92至1.27；p = 0.25）和Hb1Ac（MD −0.76%；95%CI −2.24至0.72；p = 0.31）。此外，它未增加低血糖发作（RR 2.01；95%CI 0.37至11.02；p = 0.28）。最后，利拉鲁肽降低了收缩压（MD −3.07 mmHg；95%CI −3.66至−2.48；p < 0.0001）和舒张压（MD −1.01 mmHg；95%CI −1.55至−0.47；p = 0.0003）。7项RCT存在高偏倚风险。按治疗时长和剂量进行的亚组分析结果与总体分析相似。大多数结局指标的证据质量为低或极低。结论：在非糖尿病肥胖成年人中，与安慰剂相比，利拉鲁肽降低了体重、BMI和血压。不良事件、Hb1Ac水平和低血糖发作与安慰剂无差异。
