Dutta Deep, Kamrul-Hasan A B M, Nagendra Lakshmi, Bhattacharya Saptarshi
Department of Endocrinology, CEDAR Superspeciality Healthcare, Dwarka, New Delhi, India.
Department of Endocrinology, Mymensingh Medical College, Mymensingh, Bangladesh.
touchREV Endocrinol. 2024 Oct;20(2):72-80. doi: 10.17925/EE.2024.20.2.10. Epub 2024 Jun 6.
To date, no meta-analysis has analyzed the efficacy and safety of tirzepatide as an anti-obesity medication in individuals without diabetes. This meta-analysis was undertaken to address this knowledge gap. Electronic databases were searched for randomized controlled trials (RCTs) involving individuals with obesity without diabetes receiving tirzepatide in the intervention arm and placebo in the control arm. The primary outcome was the percentage change in weight from baseline, and the secondary outcomes included the change in weight from baseline; a weight reduction of ≥5%, ≥10%, ≥15%, ≥20% and ≥25%; glycaemic parameters; lipid parameters and adverse events. From 281 initially screened articles, data from 2 RCTs involving 1,852 participants were analyzed. The efficacy and safety of tirzepatide 15 mg (or the highest tolerable dose) versus placebo were analyzed. The percentage change in body weight was higher with tirzepatide than with placebo (mean difference [MD]: -19.44%; 95% confidence interval [CI]: -22.48 to -16.41; p<0.00001). Tirzepatide also had a higher absolute reduction in body weight (MD: -17.55 kg; 95% CI: -32.15 to -2.95; p<0.00001). Higher percentages of people on tirzepatide had a weight reduction of ≥5%, ≥10%, ≥15%, ≥20% and ≥25% compared with placebo. Improvements in glycaemic and cardiometabolic parameters were observed with tirzepatide. Tirzepatide was associated with a higher number of participants with one or more adverse events, which leads to treatment discontinuation, and severe or serious gastrointestinal events. This meta-analysis provides exciting data on the impressive weight loss properties of tirzepatide over 72 weeks of clinical use in individuals with obesity without diabetes.
迄今为止，尚无荟萃分析评估替尔泊肽作为抗肥胖药物在非糖尿病个体中的疗效和安全性。本荟萃分析旨在填补这一知识空白。通过电子数据库检索随机对照试验（RCT），这些试验纳入了肥胖但无糖尿病的个体，干预组接受替尔泊肽，对照组接受安慰剂。主要结局是体重相对于基线的百分比变化，次要结局包括体重相对于基线的变化；体重减轻≥5%、≥10%、≥15%、≥20%和≥25%；血糖参数；血脂参数和不良事件。从最初筛选的281篇文章中，分析了2项RCT涉及1852名参与者的数据。分析了15 mg替尔泊肽（或最高可耐受剂量）与安慰剂相比的疗效和安全性。替尔泊肽组的体重百分比变化高于安慰剂组（平均差[MD]：-19.44%；95%置信区间[CI]：-22.48至-16.41；p<0.00001）。替尔泊肽的体重绝对降低幅度也更大（MD：-17.55 kg；95%CI：-32.15至-2.95；p<0.00001）。与安慰剂相比，接受替尔泊肽治疗的人群中体重减轻≥5%、≥10%、≥15%、≥20%和≥25%的比例更高。观察到替尔泊肽可改善血糖和心脏代谢参数。替尔泊肽与更多出现一种或多种不良事件（导致治疗中断）以及严重胃肠道事件的参与者相关。这项荟萃分析提供了令人振奋的数据，表明替尔泊肽在无糖尿病肥胖个体72周的临床使用中具有显著的减肥效果。
