Efficacy and safety of tirzepatide, GLP-1 receptor agonists, and other weight loss drugs in overweight and obesity: a network meta-analysis.

Pan, Xin-Hui; Tan, Bryan; Chin, Yip Han; Lee, Ethan Cheng Zhe; Kong, Gwyneth; Chong, Bryan; Kueh, Martin; Khoo, Chin Meng; Mehta, Anurag; Majety, Priyanka; Grandhi, Gowtham R; Dimitriadis, Georgios K; Foo, Roger; Chew, Nicholas W S; Le Roux, Carel W; Mamas, Mamas A; Chan, Mark Y

Abstract

This network meta-analysis evaluates the efficacy and safety of tirzepatide compared to glucagon-like peptide-1 receptor agonists (GLP-1 RA) and other weight loss drugs in the treatment of overweight and obesity. MEDLINE, Embase, and Cochrane CENTRAL were searched for randomized controlled trials on tirzepatide, GLP-1 RA, and weight loss drugs approved by the US Food and Drug Administration. A network meta-analysis was performed, drawing direct and indirect comparisons between treatment groups. Network diagrams and surface under the cumulative ranking curve analysis were performed for primary (≥5%, ≥10%, ≥15%, absolute weight loss) and secondary outcomes and adverse effects. Thirty-one randomized controlled trials, involving more than 35,000 patients, were included in this study. Tirzepatide 15 mg ranked in the top three across weight-related parameters, glycemic profile (glycated hemoglobin), lipid parameters (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides), and blood pressure. Tirzepatide 15 mg had the highest efficacy compared with placebo for achieving ≥15% weight loss (risk ratio 10.24, 95% CI: 6.42-16.34). As compared to placebo, tirzepatide and GLP-1 RA across all doses had significant increases in gastrointestinal adverse effects. The superiority of tirzepatide and GLP-1 RA in inducing weight loss and their ability to target multiple metabolic parameters render them promising candidates in the treatment of patients with overweight and obesity. [Abstract copyright: © 2024 The Obesity Society.]

Citation

Pan, X., Tan, B., Chin, Y. H., Lee, E. C. Z., Kong, G., Chong, B., …Chan, M. Y. (in press). Efficacy and safety of tirzepatide, GLP-1 receptor agonists, and other weight loss drugs in overweight and obesity: a network meta-analysis. Obesity, 32(5), 840-856. https://doi.org/10.1002/oby.24002

• Journal Article Type: Review
• Acceptance Date: Dec 27, 2023
• Online Publication Date: Feb 27, 2024
• Deposit Date: Mar 19, 2024
• Journal: Obesity (Silver Spring, Md.)
• Print ISSN: 1930-7381
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 32
• Issue: 5
• Pages: 840-856
• DOI: https://doi.org/10.1002/oby.24002
• Public URL: https://keele-repository.worktribe.com/output/775806