Tian Qiru, Song Yi, Deng Yan, Lin Shike
School of Basic Medical Sciences, Hainan Vocational University of Science and Technology, Haikou, China.
Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.
Front Endocrinol (Lausanne). 2025 Jul 17;16:1593134. doi: 10.3389/fendo.2025.1593134. eCollection 2025.
This meta-analysis aims to evaluate efficacy and safety of tirzepatide for weight loss, including its dose-response relationship and adverse event profile.
Studies were retrieved from high-impact journals and included phase 1 to phase 3 trials. Participants received tirzepatide at 5,10, or 15 mg doses or a placebo control. Weighted mean differences (WMD) and odds ratios (OR) with 95% confidence intervals (CIs) were used to evaluate treatment effects, and heterogeneity was assessed using I² statistic.
Tirzepatide induced a mean weight reduction of -10.39 kg versus placebo (95% CI: -10.80 to -9.99; p < 0.00001). Subgroup analyses by diabetes status showed that patients with type 2 diabetes lost -6.17 kg (95% CI: -7.16 to -5.17; p < 0.00001) at 5 mg, -8.57 kg (95% CI: -9.41 to -7.74; p < 0.00001) at 10 mg, and -9.60 kg (95% CI: -10.32 to -8.89; p < 0.00001) at 15 mg. Non-diabetic participants experienced greater absolute losses of -12.10 kg (95% CI: -13.47 to -10.72; p < 0.00001), -15.94 kg (95% CI: -17.25 to -14.62; p < 0.00001), and -17.86 kg (95% CI: -19.19 to -16.54; p < 0.00001) at the respective doses. Tirzepatide also markedly increased the odds of achieving clinically meaningful weight loss: ≥ 5% (OR=11.32; p < 0.0001), ≥ 10% (OR=14.77; p < 0.0001), and ≥ 15% (OR=18.07; p < 0.0001. Adverse events were more frequent with tirzepatide than placebo (OR=1.34; p < 0.0001), largely driven by gastrointestinal symptoms, whereas serious adverse events did not differ. Discontinuations due to side effects increased at higher doses (OR=2.31; p < 0.0001).
Tirzepatide induces significant, dose-dependent weight loss, with higher doses yielding greater reductions. While gastrointestinal side effects were common, they were generally mild to moderate and did not increase serious adverse events. These findings support tirzepatide as an effective weight management therapy, though strategies to mitigate gastrointestinal symptoms may improve adherence.
本荟萃分析旨在评估替尔泊肽减肥的疗效和安全性，包括其剂量反应关系和不良事件谱。
从高影响力期刊中检索研究，纳入1期至3期试验。参与者接受5毫克、10毫克或15毫克剂量的替尔泊肽或安慰剂对照。采用加权平均差（WMD）和95%置信区间（CI）的比值比（OR）来评估治疗效果，并使用I²统计量评估异质性。
与安慰剂相比，替尔泊肽导致平均体重减轻-10.39千克（95%CI：-10.80至-9.99；p<0.00001）。按糖尿病状态进行的亚组分析显示，2型糖尿病患者在5毫克剂量时体重减轻-6.17千克（95%CI：-7.16至-5.17；p<0.00001），10毫克剂量时体重减轻-8.57千克（95%CI：-9.41至-7.74；p<0.00001），15毫克剂量时体重减轻-9.60千克（95%CI：-10.32至-8.89；p<0.00001）。非糖尿病参与者在相应剂量下体重绝对减轻更多，分别为-12.10千克（95%CI：-13.47至-10.72；p<0.00001）、-15.94千克（95%CI：-17.25至-14.62；p<0.00001）和-17.86千克（95%CI：-19.19至-16.54；p<0.00001）。替尔泊肽还显著增加了实现具有临床意义的体重减轻的几率：体重减轻≥5%（OR=11.32；p<0.0001）、≥10%（OR=14.77；p<0.0001）和≥15%（OR=18.07；p<0.0001）。替尔泊肽组的不良事件比安慰剂组更频繁（OR=1.34；p<0.0001），主要由胃肠道症状引起，而严重不良事件无差异。因副作用导致的停药率在较高剂量时增加（OR=2.31；p<0.0001）。
替尔泊肽可导致显著的、剂量依赖性体重减轻，剂量越高减重越多。虽然胃肠道副作用常见，但一般为轻至中度，且未增加严重不良事件。这些发现支持替尔泊肽作为一种有效的体重管理疗法，不过减轻胃肠道症状的策略可能会提高依从性。
