Effects of glucagon-like peptide-1 receptor agonists on weight loss


Vilsbøll T, Christensen M, Junker AE, Knop FK, Gluud LL.
BMJ. 2012;344:d7771. doi: 10.1136/bmj.d7771. 

This overview was created under the auspices of KnowledgePoint360 Group, LLC, and was not associated with funding via an educational grant or a promotional interest. 

Vilsbøll and colleagues conducted a meta-analysis and systematic review of trials to analyze the risks and benefits of GLP-1 receptor agonists among overweight or obese subjects with type 2 diabetes.a  

Of 694 potentially applicable studies, 25 randomized, controlled trials were included in the meta-analysis. These trials were published between January 2004 and May 2011, with durations ranging from 20 to 52 weeks. Three trials included subjects who did not have diabetes; doses of study drugs were higher in these studies vs studies examining subjects with diabetes. Criteria used to diagnose diabetes and patient characteristics were similar for all trials. Liraglutide, exenatide once weekly, and exenatide twice daily were evaluated in the studies (n=8 studies, n=4 studies, n=13 studies, respectively); of the included studies, three trials provided a direct comparison between exenatide twice daily and liraglutide or exenatide once weekly.  

Results: 

Weight lossa 

  • All studies showed weight loss, which was greater among groups treated with higher dosages of GLP-1 receptor agonists 
  • Greater weight loss was seen in subjects without diabetes vs those with diabetes (-3.2 kg, 95% confidence interval [CI] -4.3 to -2.1 vs -2.8 kg, -3.4 to -2.3, respectively) 
  • In a random effects analysis of 21 trials (n=3,395 treated with GLP-1 receptor agonists, n=3,016  in control groups [placebo, insulin, or oral antidiabetic therapy]), subjects treated with GLP-1 receptor agonists demonstrated a greater weighted mean change in body weight vs subjects in the control groups (-2.9 kg, 95% CI, -3.6 to -2.2; P<0.01)  

Glycemic control among subjects with type 2 diabetes 

  • Highest doses of GLP-1 receptor agonists reduced A1C vs placebo, oral antidiabetic drugs, or insulin (Egger’s test, P=0.764) 
  • No difference observed in change in mean concentration of fasting blood glucose between the highest doses of GLP-1 receptor agonists and controls in a random effects model (-0.51 mmol/L, 95% CI, -1.09 to 0.07; χ2 test, P<0.01; Egger’s test, P=0.487). A fixed effects model demonstrated an association between GLP-1 receptor agonists and a greater reduction in fasting glucose concentrations compared with controls (-1.32 mmol/L, -1.35 to -1.29) 
  • Greater number of subjects achieved A1C <7% with GLP-1 receptor agonist treatment vs control (relative risk 1.98, 95% CI, 1.46 to 2.70; χ2 test, P=0.10) 

Adverse events  

  • Hypoglycemia, nausea, diarrhea, and vomiting were most frequent; increased along with increasing dosages of study drugs. Rate of subjects who withdrew or dropped out of the trials was not increased in the groups receiving GLP-1 receptor agonist therapy 

aThese agents are not FDA approved for weight loss. 

 

Don’t miss slides on this study in our Slide Library: 

Meta-analysis: Effects of GLP-1 Receptor Agonists on Weight Loss - Design   
Meta-analysis: Effects of GLP-1 Receptor Agonists on Weight Loss - Results 
Meta-analysis: Effects of GLP-1 Receptor Agonists on Weight Loss - Additional Results      

 

This overview was created under the auspices of KnowledgePoint360 Group, LLC, and was not associated with funding via an educational grant or a promotional interest. 

 

Last Modified: 11/15/2013