The impact of glucagon-like peptide-1 receptor agonists (GLP-1 RA) on weight loss following bariatric treatment: a systematic review and meta-analysis.

Abstract

There has been growing recognition of the need for considering weight loss strategies following metabolic bariatric surgery (MBS) to limit the magnitude of potential weight regain. The use of glucagon-like peptide-1 receptor agonists (GLP-1 RA) in this setting remains uncertain. We conducted a systematic review and meta-analysis to evaluate the effect of GLP-1 RA on weight changes in patients who previously underwent MBS. MEDLINE/PubMed, EMBASE, and Clinicaltrials.gov. Observational studies and randomized controlled trials (RCTs). We examined the impact of GLP-1 RA on weight changes by calculating pooled estimates (random-effects model) of the absolute differences in bodyweight (kg) as compared to baseline for observational studies and as compared to control group for RCTs. Seventeen studies (1164 participants) met our inclusion criteria. Pooling the data from the 14 observational studies evaluating the effect of GLP-1 RA post-bariatric treatment demonstrated a reduction of 7.83 kg as compared to pre-treatment (before the use of GLP-1 RA) [weight - 7.83 kg (95%CI: -9.27 to -6.38)]. With respect to tolerability, 23% (95%CI: 10 to 36%) of participants reported any adverse event but only 7% discontinued treatment. Data from RCTs showed that the use of GLP-1 RA induced weight reduction of 4.36 kg (95%CI: -0.42 to -8.30), as compared to placebo with similar safety profile. Our findings suggest that the use of liraglutide and semaglutide in patients who previously underwent MBS can promote significant weight reduction with acceptable safety profile. CRD42023450024.