Abstract | OBJECTIVE: DESIGN: Systematic review with meta-analyses. DATA SOURCES: Electronic searches (Cochrane Library, Medline, Embase, and Web of Science) and manual searches (up to May 2011). Review methods Randomised controlled trials of adult participants with a body mass index of 25 or higher; with or without type 2 diabetes mellitus; and who received exenatide twice daily, exenatide once weekly, or liraglutide once daily at clinically relevant doses for at least 20 weeks. Control interventions assessed were placebo, oral antidiabetic drugs, or insulin. DATA EXTRACTION: Three authors independently extracted data. We used random effects models for the primary meta-analyses. We also did subgroup, sensitivity, regression, and sequential analyses to evaluate sources of intertrial heterogeneity, bias, and the robustness of results after adjusting for multiple testing and random errors. RESULTS: 25 trials were included in the analysis. GLP-1R agonist groups achieved a greater weight loss than control groups (weighted mean difference -2.9 kg, 95% confidence interval -3.6 to -2.2; 21 trials, 6411 participants). We found evidence of intertrial heterogeneity, but no evidence of bias or small study effects in regression analyses. The results were confirmed in sequential analyses. We recorded weight loss in the GLP-1R agonist groups for patients without diabetes (-3.2 kg, -4.3 to -2.1; three trials) as well as patients with diabetes (-2.8 kg, -3.4 to -2.3; 18 trials). In the overall analysis, GLP-1R agonists had beneficial effects on systolic and diastolic blood pressure, plasma concentrations of cholesterol, and glycaemic control, but did not have a significant effect on plasma concentrations of liver enzymes. GLP-1R agonists were associated with nausea, diarrhoea, and vomiting, but not with hypoglycaemia. CONCLUSIONS:
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Authors | Tina Vilsbøll, Mikkel Christensen, Anders E Junker, Filip K Knop, Lise Lotte Gluud |
Journal | BMJ (Clinical research ed.)
(BMJ)
Vol. 344
Pg. d7771
(Jan 10 2012)
ISSN: 1756-1833 [Electronic] England |
PMID | 22236411
(Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
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Chemical References |
- Anti-Obesity Agents
- GLP1R protein, human
- Glucagon-Like Peptide-1 Receptor
- Hypoglycemic Agents
- Peptides
- Receptors, Glucagon
- Venoms
- Liraglutide
- Glucagon-Like Peptide 1
- Exenatide
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Topics |
- Anti-Obesity Agents
(therapeutic use)
- Diabetes Mellitus, Type 2
(complications, drug therapy)
- Drug Administration Schedule
- Exenatide
- Glucagon-Like Peptide 1
(analogs & derivatives, pharmacology, therapeutic use)
- Glucagon-Like Peptide-1 Receptor
- Humans
- Hypoglycemic Agents
(pharmacology, therapeutic use)
- Liraglutide
- Obesity
(complications, drug therapy)
- Overweight
(complications, drug therapy)
- Peptides
(pharmacology, therapeutic use)
- Receptors, Glucagon
(agonists)
- Treatment Outcome
- Venoms
(pharmacology, therapeutic use)
- Weight Loss
(drug effects)
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