Abstract
<p dir="ltr"><a href="" target="_blank">Background</a></p><p dir="ltr">Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have advanced rapidly in recent years.</p><p dir="ltr">Purpose</p><p dir="ltr">An updated synthesis on effects of GLP-1RAs on weight, BMI and waist circumference incorporating newer RCTs, particularly in overweight or obese patients, is timely.</p><p dir="ltr">Data Sources</p><p dir="ltr">We systematically searched PubMed, EMBASE and CENTRAL for RCTs published from inception to Oct 4, 2024.</p><p dir="ltr">Study Selection</p><p dir="ltr">The search was limited to RCTs evaluating the use of GLP1-RAs for mean differences from baseline in weight, BMI and waist circumference in obese or overweight adult patients with or without diabetes mellitus.</p><p dir="ltr">Data Extraction</p><p dir="ltr">Two independent reviewers performed the literature search and data extraction, resolving disagreements via consensus or third reviewer consultation.</p><p dir="ltr">Data Synthesis</p><p dir="ltr">47 RCTs were included with a combined cohort of 23,244 patients. GLP-1RAs demonstrated a mean weight reduction of -4.57 kg (95% CI -5.35 to -3.78), mean BMI reduction of -2.07 kg/m<sup>2</sup> (95% CI -2.53 to -1.62), and mean waist circumference reduction of -4.55 cm (95% CI -5.72 to -3.38) compared to placebo. This effect was consistent across diabetic status, GLP-1RA used and route of administration. The greatest treatment benefit appeared to favour patients who were younger, female, non-diabetic, with higher baseline weight and BMI, but lower baseline HbA1c, and treated over a longer duration.</p><p dir="ltr">Limitations</p><p dir="ltr">Limitations include substantial statistical heterogeneity, in part due to broad inclusion criteria. However, this heterogeneity may improve generalizability by reflecting a wide range of study designs and patient populations.</p><p dir="ltr">Conclusions</p><p dir="ltr">GLP-1RAs demonstrated significant weight, BMI, and waist circumference reduction benefits in this meta-analysis.</p>
Published Version
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