Abstract #1088564: The Efficacy and Safety of a SGLT2 Inhibitors on Body Weight in Obese Patients Without Diabetes: A Systematic Review and Meta-Analysis

Abstract

Sodium-glucose co-transporter-2 inhibitors (SGLT2i) have been shown to improve glycemic control, lower blood pressure and body weight in patients with type 2 diabetes mellitus (T2DM). Despite obesity being linked to increased risk for numerous diseases, management largely relies on dietary and lifestyle modifications, which are difficult to sustain. The role of SGLT2i to promote weight reduction in non-diabetic patients is a promising venture. This meta-analysis aims to evaluate weight changes in obese, non-diabetic patients who received an SGLT2i. We employed a systematic search on PubMed, Cochrane, MEDLINE, and Google Scholar databases for relevant articles, using keywords' SGLT2 inhibitors', 'Sodium-glucose co-transporter-2 inhibitors', 'body weight' and 'weight loss,' 'non-diabetic patients.' All original articles published in the English literature on this topic are selected for this study. Six relevant randomized control trials were included, with a total of 863 patients were identified. The majority were female (79%) mean age of 45.7 ± 11.8 and a body mass index (BMI) of 36.6 ± 5.0. The studies used dapagliflozin, canagliflozin, remogliflozin or sergliflozin with a dosage ranging from 10-300 mg, once to three times a day for 12 to 52 weeks. Our analysis showed a significant weight reduction with the use of SGLT2i in obese non-diabetic patients [weighted mean difference (WMD) -1.56; 95% confidence interval (CI) -2.19, -0.93; I2 = 0%]. Furthermore, BMI and waist circumference were also significantly decreased in the treatment group compared to placebo [WMD -0.5; 95% CI -0.56, -0.44; I2 = 0% and WMD -2.10; 95% CI -3.49, -0.72; I2 = 0%]. Overall, the treatment with SGLT2 inhibitors was generally safe and well-tolerated. The most common adverse event for canagliflozin was mycotic infections (10.3%), pollakiuria (frequent daytime urination) for dapagliflozin (44%), while headache for sergliflozin (33%) and remogliflozin (44%). Urinary tract infection was an adverse event reported in 4/6 studies (7.7% for canagliflozin and 5% for dapagliflozin). SGLT2 inhibitors are well tolerated and significantly reduce body weight, BMI and waist circumference in obese non-diabetic patients compared to placebo. However, the studies are short-term and vary in specific SGLT2 inhibitor received, dosage and timing. Further studies are required for a definitive conclusion.