Kamrul-Hasan Abul Bashar Mohammad, Ganakumar Vanishri, Nagendra Lakshmi, Dutta Deep, Islam M Rafiqul, Pappachan Joseph M
Department of Endocrinology, Mymensingh Medical College, Mymensingh 2200, Bangladesh.
Department of Endocrinology, Jawaharlal Nehru Medical College, Belagavi 590010, Karnataka, India.
World J Diabetes. 2025 May 15;16(5):103244. doi: 10.4239/wjd.v16.i5.103244.
Beinaglutide, a short-acting glucagon-like polypeptide-1 receptor agonist, has shown variable efficacy in weight reduction and metabolic control in randomized controlled trials (RCTs).
To summarize the therapeutic effects of beinaglutide in patients with overweight/obesity with/without type 2 diabetes.
RCTs involving patients receiving beinaglutide in the intervention arm and placebo or active comparator in the control arm were searched through multiple electronic databases. The change from baseline in body weight was the primary outcome; secondary outcomes included changes in body mass index (BMI), waist circumference (WC), blood pressure, glycemic parameters, lipids, and adverse events (AEs). RevMan web was used to conduct meta-analysis using random-effects models. Outcomes were presented as mean differences (MDs), odds ratios (ORs), or risk ratios (RRs) with 95% confidence intervals (95%CIs).
Six RCTs ( = 800) with mostly some concerns about the risk of bias were included. Over 12-24 weeks, beinaglutide 0.1-0.2 mg thrice daily was superior to the control group in reducing total (MD = -3.25 kg, 95%CI: -4.52 to -1.98, = 84%, < 0.00001) and percent (MD = -4.13%, 95%CI: -4.87 to -3.39, = 54%, < 0.00001) body weight reduction. Beinaglutide also outperformed the control group in achieving weight loss by 5% (OR 4.61) and 10% (OR = 5.34). The superiority of beinaglutide the control group was also found in reducing BMI (MD = -1.22 kg/m, 95%CI: -1.67 to -0.77) and WC (MD = -2.47 cm, 95%CI: -3.74 to -1.19]). Beinaglutide and the control group had comparable impacts on blood pressure, glycemic parameters, insulin resistance, hepatic transaminases, and lipid profile. Beinaglutide posed higher risks of treatment discontinuation due to AEs (RR = 3.15), nausea (RR = 4.51), vomiting (RR = 8.19), palpitation (RR = 3.95), headache (RR = 2.87), and dizziness (RR = 6.07) than the control. However, the two groups had identical risks of total and serious AEs, diarrhea, fatigue, and hypoglycemia.
Short-term data from RCTs suggested that beinaglutide causes modest benefits in reducing body weight, BMI, and WC, with no significant difference in glycemic and other metabolic endpoints compared to the control arm. Safety data were consistent with those of the other drugs in the glucagon-like polypeptide-1 receptor agonist class. Larger RCTs are warranted to prove the longer-term metabolic benefits of beinaglutide.
贝那鲁肽是一种短效胰高血糖素样肽-1受体激动剂，在随机对照试验（RCT）中，其在减重和代谢控制方面的疗效存在差异。
总结贝那鲁肽对伴有或不伴有2型糖尿病的超重/肥胖患者的治疗效果。
通过多个电子数据库检索RCT，干预组为接受贝那鲁肽治疗的患者，对照组为接受安慰剂或活性对照药治疗的患者。体重相对于基线的变化为主要结局；次要结局包括体重指数（BMI）、腰围（WC）、血压、血糖参数、血脂及不良事件（AE）的变化。使用RevMan网络版软件采用随机效应模型进行荟萃分析。结局以均数差（MD）、比值比（OR）或风险比（RR）及95%置信区间（95%CI）表示。
纳入6项RCT（n = 800），这些研究大多在偏倚风险方面存在一些问题。在12 - 24周期间，每日三次皮下注射0.1 - 0.2 mg贝那鲁肽在降低总体重（MD = -3.25 kg，95%CI：-4.52至-1.98，I² = 84%，P < [此处原文有误，应为P]<0.00001）和体重百分比（MD = -4.13%，95%CI：-4.87至-3.39，I² = 54%，P < 0.00001）方面优于对照组。贝那鲁肽在实现体重减轻5%（OR = 4.61）和10%（OR = 5.34）方面也优于对照组。在降低BMI（MD = -1.22 kg/m²，95%CI：-1.67至-0.77）和WC（MD = -2.47 cm，95%CI：-3.74至-1.19）方面，贝那鲁肽同样优于对照组。贝那鲁肽与对照组对血压、血糖参数、胰岛素抵抗、肝转氨酶和血脂谱的影响相当。因AE导致治疗中断（RR = 3.15）、恶心（RR = 4.51）、呕吐（RR = 8.19）、心悸（RR = 3.95）、头痛（RR = 2.87）和头晕（RR = 6.07）的风险方面，贝那鲁肽高于对照组。然而，两组在总体AE和严重AE、腹泻、疲劳及低血糖方面的风险相同。
RCT的短期数据表明，贝那鲁肽在减轻体重、BMI和WC方面有一定益处，与对照组相比，血糖及其他代谢终点无显著差异。安全性数据与其他胰高血糖素样肽-1受体激动剂类药物一致。需要更大规模的RCT来证实贝那鲁肽的长期代谢益处。
