Abstract
Glucagon-Like Peptide-1 receptor agonists (GLP-1RAs), approved as glucose-lowering drugs for the treatment of type 2 diabetes, have also been shown to reduce body weight. An extensive Medline, Cochrane database, and Embase search for “exenatide,” “liraglutide,” “albiglutide,” “semaglutide,” and “lixisenatide” was performed, collecting all randomized clinical trials on humans up to December 15, 2011, with a duration of at least 24 weeks, comparing GLP-1 receptor agonists with either placebo or active drugs. Twenty two (7,859 patients) and 7 (2,416 patients) trials with available results on body weight at 6 and 12 months, respectively, were included. When compared with placebo, GLP-1RAs determine a reduction of BMI at 6 months of −1.0 [−1.3; −0.6] kg/m2. Considering the average BMI at baseline (32.4 kg/m2) these data means a weight reduction of about 3% at 6 months. This result could seem modest from a clinical standpoint; however, it could be affected by many factors contributing to an underestimation of the effect of GLP-1RA on body weight, such as non adequate doses, inclusion criteria, efficacy of GLP-1RA on reducing glycosuria, and association to non-pharmacological interventions not specifically aimed to weight reduction.
Highlights
Most drugs developed for the therapy of obesity have failed to show a sufficient efficacy and safety for long-term treatment
Long-acting Glucagon-like peptide-1 (GLP-1) receptor agonists, which can be administered via subcutaneous injection once or twice a day or once a week, have been developed as glucoselowering drugs for the treatment of type 2 diabetes [4], but they have been shown to reduce body weight [5, 6]
Results on body mass index (BMI) at 12 months were available in 7 trials, 6 of which were performed in patients with diabetes
Summary
Most drugs developed for the therapy of obesity have failed to show a sufficient efficacy and safety for long-term treatment. Glucagon-like peptide-1 (GLP-1) is a gastrointestinal hormone, produced mainly in the postprandial phase, which stimulates insulin secretion and inhibits glucagon release in a dose-dependent fashion [2]. Due to this properties, the hormone reduces hyperglycemia without inducing hypoglycemia in patients with type 2 diabetes [3]. Long-acting GLP-1 receptor agonists, which can be administered via subcutaneous injection once or twice a day or once a week, have been developed as glucoselowering drugs for the treatment of type 2 diabetes [4], but they have been shown to reduce body weight [5, 6]. One of the side effect of GLP-1 receptor agonists, nausea (sometimes associated with vomiting), could contribute to the weight
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