Abstract
Objective: To evaluate the efficacy and safety of liraglutide as a coadjuvant medication to reduce the body mass index (BMI) in overweight (BMI: 25-30 kg/m2) and obesity (BMI: > 30 kg/m2) worldwide.
Materials and methods: A search of studies was carried out in several databases (TRIP, Embase, Pubmed, Scopus, Epistemonikos, Cochrane and ClinicalKey), the outcome evaluated was the decrease in weight with the use of liraglutide. We use the PRISMA 2009 tool in order to obtain a systematic review.
Results: A total of 74 studies, 3 randomized clinical trials were included, evaluating 4281 participants. Weight loss was the main outcome, and adverse events were secondary outcomes. Meta-analysis was carried out with a weight loss report of -5.22 (95% confidence interval [CI]: - 5.95, -4.50), inconsistency index (I²) with high heterogeneity, as well as the meta-regression performed. Adverse events are evidenced more frequently in the liraglutide group, Gastrointestinal events were the most reported.
Conclusion: The individual results in the studies demonstrate that the use of liraglutide reduces weight. However, this systematic review shows that there is no statistical significance of the evidence for heterogeneity of the studies evaluated.
References
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Frøssing S, Nylander M, Chabanova E, Frystyk J, Holst JJ, Kistorp C, et al. Effect of liraglutide on ectopic fat in polycystic ovary syndrome: A randomized clinical trial. Diabetes Obes Metab. 2018;20(1):215-218.
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Wadden TA, Stunkard AJ. Social and psychological consequences of obesity. Ann Intern Med. 1985;103(6 ( Pt 2)):1062-7.
García Milian AJ, Creus García ED. La obesidad como factor de riesgo, sus determinantes y tratamiento. Rev Cubana Med Gen Integr. 2016;32(3).
Warkentin LM, Das D, Majumdar SR, Johnson JA, Padwal RS. The effect of weight loss on health-related quality of life: systematic review and meta-analysis of randomized trials. Obes Rev. 2014;15(3):169-82.
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Halawi H, Khemani D, Eckert D, O’Neill J, Kadouh H, Grothe K, et al. Effects of liraglutide on weight, satiation, and gastric functions in obesity: a randomised, placebo-controlled pilot trial. Lancet Gastroenterol Hepatol. 2017;2(12):890-899.
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Blackman A, Foster GD, Zammit G, Rosenberg R, Aronne L, Wadden T, et al. Effect of liraglutide 3.0 mg in individuals with obesity and moderate or severe obstructive sleep apnea: the SCALE Sleep Apnea randomized clinical trial. Int J Obes (Lond). 2016;40(8):1310-9.
Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, et al. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. N Engl J Med. 2015;373(1):11-22.
Guyatt GH, Oxman AD, Sultan S, Glasziou P, Akl EA, Alonso-Coello P, et al. GRADE guidelines: 9. Rating up the quality of evidence. J Clin Epidemiol. 2011;64(12):1311-6.
Mehta A, Marso SP, Neeland IJ. Liraglutide for weight management: a critical review of the evidence. Obes Sci Pract. 2017;3(1):3-14.
Khera R, Murad MH, Chandar AK, Dulai PS, Wang Z, Prokop LJ, et al. Association of Pharmacological Treatments for Obesity With Weight Loss and Adverse Events: A Systematic Review and Meta-analysis. JAMA. 2016;315(22):2424-34.
Obesidad y sobrepeso [internet]. OMS; 2020 [citado el 26 de mayo de 2020]. Disponible en: http://www.who.int/es/news-room/fact-sheets/detail/obesity-and-overweight
Panorama de la seguridad alimentaria y nutricional en América Latina y el Caribe. Santiago de Chile: FAO, OPS, WFP, UNICEF; 2019.
Panorama de la seguridad alimentaria y nutricional en América Latina y el Caribe. Santiago de Chile: FAO, OPS, WFP, UNICEF; 2018.
Cardiovascular diseases (CVDs) [Internet]. World Health Organization; 2014 [actualizado el 1 de mayo de 2017; consultado 26 de mayo de 2020. Disponible en: https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
le Roux CW, Astrup A, Fujioka K, Greenway F, Lau DCW, Van Gaal L, et al. 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial. Lancet. 2017;389(10077):1399-1409.
Frøssing S, Nylander M, Chabanova E, Frystyk J, Holst JJ, Kistorp C, et al. Effect of liraglutide on ectopic fat in polycystic ovary syndrome: A randomized clinical trial. Diabetes Obes Metab. 2018;20(1):215-218.
Jensen MD. Obesidad. Goldman-Cecil. En: Tratado de Medicina Interna [Internet]. Barcelona: Elsevier; 2016. p. 1458-67. Disponible en: https://www.clinicalkey.es/#!/content/3-s2.0 B9788491130338002202?scrollTo=%23c1100
Stunkard AJ, Wadden TA. Psychological aspects of severe obesity. Am J Clin Nutr. 1992;55(2 Suppl):524S-532S.
Wadden TA, Stunkard AJ. Social and psychological consequences of obesity. Ann Intern Med. 1985;103(6 ( Pt 2)):1062-7.
García Milian AJ, Creus García ED. La obesidad como factor de riesgo, sus determinantes y tratamiento. Rev Cubana Med Gen Integr. 2016;32(3).
Warkentin LM, Das D, Majumdar SR, Johnson JA, Padwal RS. The effect of weight loss on health-related quality of life: systematic review and meta-analysis of randomized trials. Obes Rev. 2014;15(3):169-82.
Mertens IL, Van Gaal LF. Overweight, obesity, and blood pressure: the effects of modest weight reduction. Obes Res. 2000;8(3):270-8.
Montesi L, El Ghoch M, Brodosi L, Calugi S, Marchesini G, Dalle Grave R. Long-term weight loss maintenance for obesity: a multidisciplinary approach. Diabetes Metab Syndr Obes. 2016;9:37-46.
Fernández-Ruiz VE, Armero-Barranco D, Paniagua-Urbano JA, Sole-Agusti M, Ruiz-Sánchez A, Gómez-Marín J. Short-medium-long-term efficacy of interdisciplinary intervention against overweight and obesity: Randomized controlled clinical trial. Int J Nurs Pract. 2018;24(6):e12690.
Recomendaciones mundiales sobre actividad física para la salud. Ginebra: WHO; 2010.
Rane SD, Gore JC. Measurement of T1 of human arterial and venous blood at 7T. Magn Reson Imaging. 2013;31(3):477-9.
Halawi H, Khemani D, Eckert D, O’Neill J, Kadouh H, Grothe K, et al. Effects of liraglutide on weight, satiation, and gastric functions in obesity: a randomised, placebo-controlled pilot trial. Lancet Gastroenterol Hepatol. 2017;2(12):890-899.
Ficha de medicamento liraglutide. clinicalkey [citado 23 de octubre 2019]. Disponible en: https://www.clinicalkey.es/#!/content/drug_monograph/6-s2.0 3496?scrollTo=%23MonitoringParameters
Garber AJ, Handelsman Y, Grunberger G, Einhorn D, Abrahamson MJ, Barzilay JI, et al. Consensus statement by the American association of clinical endocrinologists and American college of endocrinology on the comprehensive type 2 diabetes management algorithm - 2020 executive summary. Endocr Pract. 2020;26(1):107-139.
U.S. Food & Drug Administration (FDA). Postmarket Drug and Biologic Safety Evaluations Completed from January 2017 - March 2017. Maryland: FDA; 2017 [citado 23 de octubre 2019]. Disponible en: https://www.fda.gov/drugs/surveillance/postmarket-drug-and-biologic-safety-evaluations-completed- january-2017-march-2017.
Ministerio de Salud y la Protección social, Instituto Nacional de Vigilancia de Medicamentos y Alimentos (Invima). Acta No. 25 de 2015, Sesión extraordinaria virtual, 23, 24 y 25 de noviembre de 2015. Bogotá D.C: Invima; 2015.
Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration; 2011 [actualizado en marzo de 2011; citado 4 de mayo 2020. Disponible en: https://handbook-5-1.cochrane.org/
Astrup A, Carraro R, Finer N, Harper A, Kunesova M, Lean ME, et al. Safety, tolerability and sustained weight loss over 2 years with the once-daily human GLP-1 analog, liraglutide. Int J Obes (Lond). 2012;36(6):843-54.
Blackman A, Foster GD, Zammit G, Rosenberg R, Aronne L, Wadden T, et al. Effect of liraglutide 3.0 mg in individuals with obesity and moderate or severe obstructive sleep apnea: the SCALE Sleep Apnea randomized clinical trial. Int J Obes (Lond). 2016;40(8):1310-9.
Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, et al. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. N Engl J Med. 2015;373(1):11-22.
Guyatt GH, Oxman AD, Sultan S, Glasziou P, Akl EA, Alonso-Coello P, et al. GRADE guidelines: 9. Rating up the quality of evidence. J Clin Epidemiol. 2011;64(12):1311-6.
Mehta A, Marso SP, Neeland IJ. Liraglutide for weight management: a critical review of the evidence. Obes Sci Pract. 2017;3(1):3-14.
Khera R, Murad MH, Chandar AK, Dulai PS, Wang Z, Prokop LJ, et al. Association of Pharmacological Treatments for Obesity With Weight Loss and Adverse Events: A Systematic Review and Meta-analysis. JAMA. 2016;315(22):2424-34.
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