Association of Glucagon-like Peptide 1 Analogs and Agonists Administered for Obesity with Weight Loss and Adverse Events: A Systematic Review and Network Meta-analysis

ABSTRACT: Background: Comparative effectiveness of 7 glucagon-like peptide 1 (GLP-1) agents on weight loss (WL) in obesity remains unknown. Methods: We performed a systematic review, network meta-analysis (NMA) utilizing the following data sources: MEDLINE, EMBASE, Scopus, Cochrane Central and clin...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Kia Vosoughi, Jessica Atieh, Lehar Khanna, Katayoun Khoshbin, Larry J. Prokop, Perica Davitkov, M. Hassan Murad, Michael Camilleri
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/2b91c305c8734797ae3c417238d6663c
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:2b91c305c8734797ae3c417238d6663c
record_format	dspace
spelling	oai:doaj.org-article:2b91c305c8734797ae3c417238d6663c2021-11-28T04:37:14ZAssociation of Glucagon-like Peptide 1 Analogs and Agonists Administered for Obesity with Weight Loss and Adverse Events: A Systematic Review and Network Meta-analysis2589-537010.1016/j.eclinm.2021.101213https://doaj.org/article/2b91c305c8734797ae3c417238d6663c2021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2589537021004946https://doaj.org/toc/2589-5370ABSTRACT: Background: Comparative effectiveness of 7 glucagon-like peptide 1 (GLP-1) agents on weight loss (WL) in obesity remains unknown. Methods: We performed a systematic review, network meta-analysis (NMA) utilizing the following data sources: MEDLINE, EMBASE, Scopus, Cochrane Central and clinical trial registries, from inception to March 2, 2021. The prespecified criteria for study inclusion were randomized clinical trials (RCTs) of ≥12 weeks’ duration. The data appraisal and extraction were performed by two investigators independently, using the published reports. The main outcomes and statistical methods were weight loss over placebo (WLOP) and adverse events (AEs) among GLP-1 agents using random-effects NMA (frequentist approach); relative ranking using surface under the cumulative ranking (SUCRA) method and certainty of evidence using grading of recommendations, assessment, development and evaluations (GRADE). Findings: 64 RCTs (from 2004 to 2021) included 27018 patients (median of age, 55.1 years old; 57.4% women; baseline weight 94.8kg and BMI 33.0kg/m2; trial duration 26 weeks). Direct meta-analysis showed significant WLOP with: -1.44kg (95% CI, -2.14 to -0.74) with dulaglutide ≥1.5 mg; -1.82kg (-2.42 to -1.23) with exenatide immediate release (IR); -2.20kg (-4.31 to -0.08) with exenatide extended release (ER); -3.20kg (-6.53 to 0.15) with efpeglenatide; -2.72kg (-3.35 to -2.09) with liraglutide ≤1.8mg; -4.49kg (-5.26 to -3.72) with liraglutide >1.8mg; -0.62kg (-1.22 to -0.02) with lixisenatide; -4.33kg (-5.71 to -3.00) with semaglutide SQ <2.4mg; -9.88kg (-13.17 to -6.59) with semaglutide SQ 2.4mg; -2.73kg (-4.81 to -0.65) with semaglutide oral; and -1.71kg (-2.64 to -0.78) with taspoglutide. Highest WLOP were with semaglutide SQ 2.4mg and <2.4mg, and liraglutide >1.8mg (SUCRAs 100, 86.1, 82.8 respectively). Highest SUCRAs for discontinuation due to AEs were with taspoglutide and liraglutide >1.8mg. Risk of bias was high or unclear for random sequence generation (29.7%), allocation concealment (26.6%), and incomplete outcome data (26.6%). Heterogeneity (I2 >50%) in WL and AEs reflected magnitude, not direction of effect.Kia VosoughiJessica AtiehLehar KhannaKatayoun KhoshbinLarry J. ProkopPerica DavitkovM. Hassan MuradMichael CamilleriElsevierarticleMedicine (General)R5-920ENEClinicalMedicine, Vol 42, Iss , Pp 101213- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 Kia Vosoughi Jessica Atieh Lehar Khanna Katayoun Khoshbin Larry J. Prokop Perica Davitkov M. Hassan Murad Michael Camilleri Association of Glucagon-like Peptide 1 Analogs and Agonists Administered for Obesity with Weight Loss and Adverse Events: A Systematic Review and Network Meta-analysis
description	ABSTRACT: Background: Comparative effectiveness of 7 glucagon-like peptide 1 (GLP-1) agents on weight loss (WL) in obesity remains unknown. Methods: We performed a systematic review, network meta-analysis (NMA) utilizing the following data sources: MEDLINE, EMBASE, Scopus, Cochrane Central and clinical trial registries, from inception to March 2, 2021. The prespecified criteria for study inclusion were randomized clinical trials (RCTs) of ≥12 weeks’ duration. The data appraisal and extraction were performed by two investigators independently, using the published reports. The main outcomes and statistical methods were weight loss over placebo (WLOP) and adverse events (AEs) among GLP-1 agents using random-effects NMA (frequentist approach); relative ranking using surface under the cumulative ranking (SUCRA) method and certainty of evidence using grading of recommendations, assessment, development and evaluations (GRADE). Findings: 64 RCTs (from 2004 to 2021) included 27018 patients (median of age, 55.1 years old; 57.4% women; baseline weight 94.8kg and BMI 33.0kg/m2; trial duration 26 weeks). Direct meta-analysis showed significant WLOP with: -1.44kg (95% CI, -2.14 to -0.74) with dulaglutide ≥1.5 mg; -1.82kg (-2.42 to -1.23) with exenatide immediate release (IR); -2.20kg (-4.31 to -0.08) with exenatide extended release (ER); -3.20kg (-6.53 to 0.15) with efpeglenatide; -2.72kg (-3.35 to -2.09) with liraglutide ≤1.8mg; -4.49kg (-5.26 to -3.72) with liraglutide >1.8mg; -0.62kg (-1.22 to -0.02) with lixisenatide; -4.33kg (-5.71 to -3.00) with semaglutide SQ <2.4mg; -9.88kg (-13.17 to -6.59) with semaglutide SQ 2.4mg; -2.73kg (-4.81 to -0.65) with semaglutide oral; and -1.71kg (-2.64 to -0.78) with taspoglutide. Highest WLOP were with semaglutide SQ 2.4mg and <2.4mg, and liraglutide >1.8mg (SUCRAs 100, 86.1, 82.8 respectively). Highest SUCRAs for discontinuation due to AEs were with taspoglutide and liraglutide >1.8mg. Risk of bias was high or unclear for random sequence generation (29.7%), allocation concealment (26.6%), and incomplete outcome data (26.6%). Heterogeneity (I2 >50%) in WL and AEs reflected magnitude, not direction of effect.
format	article
author	Kia Vosoughi Jessica Atieh Lehar Khanna Katayoun Khoshbin Larry J. Prokop Perica Davitkov M. Hassan Murad Michael Camilleri
author_facet	Kia Vosoughi Jessica Atieh Lehar Khanna Katayoun Khoshbin Larry J. Prokop Perica Davitkov M. Hassan Murad Michael Camilleri
author_sort	Kia Vosoughi
title	Association of Glucagon-like Peptide 1 Analogs and Agonists Administered for Obesity with Weight Loss and Adverse Events: A Systematic Review and Network Meta-analysis
title_short	Association of Glucagon-like Peptide 1 Analogs and Agonists Administered for Obesity with Weight Loss and Adverse Events: A Systematic Review and Network Meta-analysis
title_full	Association of Glucagon-like Peptide 1 Analogs and Agonists Administered for Obesity with Weight Loss and Adverse Events: A Systematic Review and Network Meta-analysis
title_fullStr	Association of Glucagon-like Peptide 1 Analogs and Agonists Administered for Obesity with Weight Loss and Adverse Events: A Systematic Review and Network Meta-analysis
title_full_unstemmed	Association of Glucagon-like Peptide 1 Analogs and Agonists Administered for Obesity with Weight Loss and Adverse Events: A Systematic Review and Network Meta-analysis
title_sort	association of glucagon-like peptide 1 analogs and agonists administered for obesity with weight loss and adverse events: a systematic review and network meta-analysis
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/2b91c305c8734797ae3c417238d6663c
work_keys_str_mv	AT kiavosoughi associationofglucagonlikepeptide1analogsandagonistsadministeredforobesitywithweightlossandadverseeventsasystematicreviewandnetworkmetaanalysis AT jessicaatieh associationofglucagonlikepeptide1analogsandagonistsadministeredforobesitywithweightlossandadverseeventsasystematicreviewandnetworkmetaanalysis AT leharkhanna associationofglucagonlikepeptide1analogsandagonistsadministeredforobesitywithweightlossandadverseeventsasystematicreviewandnetworkmetaanalysis AT katayounkhoshbin associationofglucagonlikepeptide1analogsandagonistsadministeredforobesitywithweightlossandadverseeventsasystematicreviewandnetworkmetaanalysis AT larryjprokop associationofglucagonlikepeptide1analogsandagonistsadministeredforobesitywithweightlossandadverseeventsasystematicreviewandnetworkmetaanalysis AT pericadavitkov associationofglucagonlikepeptide1analogsandagonistsadministeredforobesitywithweightlossandadverseeventsasystematicreviewandnetworkmetaanalysis AT mhassanmurad associationofglucagonlikepeptide1analogsandagonistsadministeredforobesitywithweightlossandadverseeventsasystematicreviewandnetworkmetaanalysis AT michaelcamilleri associationofglucagonlikepeptide1analogsandagonistsadministeredforobesitywithweightlossandadverseeventsasystematicreviewandnetworkmetaanalysis
_version_	1718408248846974976

Association of Glucagon-like Peptide 1 Analogs and Agonists Administered for Obesity with Weight Loss and Adverse Events: A Systematic Review and Network Meta-analysis

Ejemplares similares