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from: Kaohsiung
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from: yunlin
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from: taizhong
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from: Kaohsiung
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| 2021-12-14 14:39:52 | onclick： | Systematic review and network meta-analysis of drug therapy in overweight and obese adults |
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Li sheyu's team from West China Hospital of Sichuan University conducted a systematic review and network meta-analysis on the drug treatment of overweight and obese adults. This research result was published in the lancet on December 8, 2021.
Drug therapy provides an option for overweight and obese adults to lose weight if lifestyle changes fail. The research team summarized the latest evidence on the advantages and disadvantages of weight-loss drugs.
This systematic review and network meta-analysis from PubMed Emabase and Cochrane Libraries (central) and other large databases were searched for the literature from the establishment of the database to March 23, 2021, selected the randomized controlled trials of weight loss drugs for overweight and obese adults, conducted frequency random effect network meta-analysis to summarize the evidence, rated the certainty of the evidence by using the proposed hierarchical evaluation, development and evaluation framework, calculated the absolute effect, and evaluated the intervention measures Classify and present the results.
The study team identified 14605 literatures, of which 143 qualified trials registered 49810 participants. Except for L-carnitine, all drugs can reduce weight more than changing lifestyle alone; All follow-up indicators refer to the comparison with lifestyle changes.
High to moderate conclusive evidence shows that, Fentamine topiramate was the most effective in weight loss (odds ratio for weight loss ≥ 5% was 8.02), followed by GLP-1 receptor agonist (6.33). Naltrexone bupropion (odds ratio 2.69), fentamine topiramate (2.40), GLP-1 receptor agonist (2.17) and orlistat (1.72) were associated with increased adverse events leading to withdrawal.
In a post hoc analysis, the GLP-1 receptor agonist semaglutide showed greater benefits than other drugs with similar risk of adverse events in terms of the possibility of weight loss of 5% or more (9.82) and the percentage of weight change (MD).
The results show that phentermine topiramate and GLP-1 receptor agonists have been proved to be the best weight loss drugs for overweight and obese adults; Among GLP-1 agonists, semaglutide may be the most effective.
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