Ferraz Barbosa Bárbara, Aquino de Moraes Francisco Cezar, Bordignon Barbosa Camila, Palavicini Santos Plínio Takashi Karubi, Pereira da Silva Izael, Araujo Alves da Silva Bruno, Cristine Marques Barros Jamile, Rodríguez Burbano Rommel Mario, Pereira Carneiro Dos Santos Ney, Rodrigues Fernandes Marianne
Department of Medicine, University of Aquino Bolivia, Santa Cruz de la Sierra 0701, Bolivia.
Oncology Research Center, Federal University of Pará, Belém 66073-005, PA, Brazil.
J Pers Med. 2023 Oct 4;13(10):1460. doi: 10.3390/jpm13101460.
A malfunction in the melanocortin-4 receptor (MC4R) is associated with obesity in rare genetic syndromes; setmelanotide is a new drug that activates this receptor and is being used to treat severe obesity. This meta-analysis evaluated the efficacy and safety of setmelanotide for weight loss in severe obesity linked to human MC4R deficiency.
We searched PubMed, Embase, and Cochrane for randomized and nonrandomized clinical trials using setmelanotide. We considered a -value ≤ 0.05 statistically significant.
We included 376 patients, of whom 328 (87.2%) received setmelanotide for a mean follow-up of 52 weeks. The mean age was 32.8 (14.67) years. Weight loss was significant (MD -3.52; 95% CI -3.98, -3.05; = 0.01; I = 92%), with an average proportion of -6.91% weight loss during treatment. Changes in BMI showed an MD of -10.55 kg/m in patients > 18 years and -0.61 kg/m in patients < 18 years (BMI score). However, the drug was associated with a higher risk of skin hyperpigmentation (OR 0.69; 95% CI 0.55, 0.80; = 0.08).
Our results support the use of setmelanotide in treating severe obesity.
黑皮质素-4受体（MC4R）功能异常与罕见遗传综合征中的肥胖症有关；setmelanotide是一种激活该受体的新药，正用于治疗重度肥胖症。这项荟萃分析评估了setmelanotide对与人类MC4R缺乏相关的重度肥胖症患者体重减轻的疗效和安全性。
我们在PubMed、Embase和Cochrane中检索了使用setmelanotide的随机和非随机临床试验。我们认为P值≤0.05具有统计学意义。
我们纳入了376例患者，其中328例（87.2%）接受了setmelanotide治疗，平均随访52周。平均年龄为32.8（14.67）岁。体重减轻显著（MD -3.52；95%CI -3.98，-3.05；P = 0.01；I² = 92%），治疗期间平均体重减轻比例为-6.91%。BMI变化显示，18岁以上患者的MD为-10.55 kg/m²，18岁以下患者的MD为-0.61 kg/m²（BMI评分）。然而，该药物与皮肤色素沉着过度的风险较高相关（OR 0.69；95%CI 0.55，0.80；P = 0.08）。
我们的结果支持使用setmelanotide治疗重度肥胖症。
