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利拉鲁肽 3.0mg 大剂量治疗对减重手术反应不佳患者的疗效:真实世界经验和更新的荟萃分析。

Efficacy of High-dose Liraglutide 3.0 mg in Patients with Poor Response to Bariatric Surgery: Real-world Experience and Updated Meta-analysis.

机构信息

Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia, 89, 95123, Catania, Italy.

General and Emergency Surgery Department, Garibaldi Hospital, 95122, Catania, Italy.

出版信息

Obes Surg. 2024 Feb;34(2):303-309. doi: 10.1007/s11695-023-07053-9. Epub 2024 Jan 6.

Abstract

PURPOSE

Poor response to bariatric surgery, characterized by insufficient weight loss (IWL) or weight regain (WR), poses a significant challenge in obesity treatment. This study aims to assess the effectiveness of liraglutide in addressing this issue.

MATERIALS AND METHODS

A retrospective, multicenter cohort study investigated the impact of liraglutide 3 mg on weight loss in adults with suboptimal responses or weight regain after bariatric surgery (BS). Additionally, a systematic review and meta-analysis were conducted for a comprehensive evaluation.

RESULTS

A total of 119 patients (mean age 41.03 ± 11.2 years, 71.4% female) who experienced IWL or WR after BS received pharmacologic therapy with liraglutide 3 mg. Mean percent weight loss in the entire cohort was 5.6 ± 2.6% at 12 weeks and 9.3 ± 3.6% at 24 weeks with a significant reduction in waist circumference (p < 0.0001). No serious side effects were reported. A meta-analysis, utilizing the fixed effect model with the metafor package in R, included 6 and 5 papers for the change in body weight and BMI after liraglutide treatment, respectively. The analysis demonstrated a considerable reduction in body weight (7.9; CI - 10.4; - 5.4, p < 0.0001) and BMI (3.09; CI 3.89; - 2.28, p < 0.0001).

CONCLUSION

Liraglutide 3 mg emerges as a viable option for significant weight loss in patients experiencing IWL or WR after BS. Its inclusion in a multimodal, sequential obesity treatment approach proves promising.

摘要

目的

减重手术后反应不佳,表现为体重减轻不足(IWL)或体重反弹(WR),这是肥胖治疗面临的重大挑战。本研究旨在评估利拉鲁肽在此问题上的疗效。

材料与方法

一项回顾性、多中心队列研究调查了利拉鲁肽 3mg 对接受减重手术后对 IWL 或 WR 的成年人的体重减轻的影响。此外,还进行了系统评价和荟萃分析,以进行全面评估。

结果

共有 119 名(平均年龄 41.03±11.2 岁,71.4%为女性)在 BS 后经历 IWL 或 WR 的患者接受了利拉鲁肽 3mg 的药物治疗。整个队列在 12 周和 24 周时的平均体重减轻百分比分别为 5.6±2.6%和 9.3±3.6%,腰围显著减少(p<0.0001)。未报告严重副作用。一项荟萃分析,利用 R 中的 metafor 包中的固定效应模型,纳入了 6 篇和 5 篇关于利拉鲁肽治疗后体重和 BMI 变化的论文。分析表明体重显著减轻(7.9;CI-10.4;-5.4,p<0.0001)和 BMI 降低(3.09;CI 3.89;-2.28,p<0.0001)。

结论

利拉鲁肽 3mg 是 BS 后 IWL 或 WR 患者显著减轻体重的可行选择。将其纳入多模式、序贯肥胖治疗方法具有广阔前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ff7/10811090/7fc5c09e89e6/11695_2023_7053_Fig1_HTML.jpg

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