Medicines for the management of overweight and obesity: A systematic review with network meta-analysis
Abstract To synthesize the evidence about pharmacologic treatment of obesity and overweight and to define the options with the best risk-benefit using the stochastic analysis of multicriteria acceptability (SMAA). The analysis addresses a systematic review (PROSPERO CRD42023423308) whose research wa...
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| Format: | Article |
| Language: | English |
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Universidade de São Paulo
2025-01-01
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| Series: | Brazilian Journal of Pharmaceutical Sciences |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1984-82502025000100804&lng=en&tlng=en |
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| author | Gabriela Masiero Marcon Jhonatan Mendes Paiva Mariana Delariva Sakiyama Fernanda Stumpf Tonin Fernando Fernandez-Llimos Suzane Virtuoso Andreia Cristina Conegero Sanches |
| author_facet | Gabriela Masiero Marcon Jhonatan Mendes Paiva Mariana Delariva Sakiyama Fernanda Stumpf Tonin Fernando Fernandez-Llimos Suzane Virtuoso Andreia Cristina Conegero Sanches |
| author_sort | Gabriela Masiero Marcon |
| collection | DOAJ |
| description | Abstract To synthesize the evidence about pharmacologic treatment of obesity and overweight and to define the options with the best risk-benefit using the stochastic analysis of multicriteria acceptability (SMAA). The analysis addresses a systematic review (PROSPERO CRD42023423308) whose research was realized in PubMed, Scopus, and Web of Science. Randomized controlled trials were included, which verified the effects of sibutramine, orlistat, liraglutide, and semaglutide in patients with IMC ≥ 26 Kg/ m². The risk of bias analysis was performed with RoB 2.0 and the outcomes evaluated were weight loss and serious adverse events. A total of 102 studies with 45.047 participants were included. The network meta-analysis revealed that all the treatments were significantly more effective than the placebo in weight reduction. The use of semaglutide (especially 0.4 mg/day) was associated with a bigger weight loss in comparison to all the other treatments (p<0.05) and the analysis of SMAA showed a risk-benefit of 95%. Besides that, we suggest re-evaluating of sibutramine 10mg/day as a therapeutic option for patients without hypertension or cardiovascular diseases, and we demonstrate the modest weight loss promoted by orlistat 120mg, sibutramine 5mg, and liraglutide 1,8mg and advise against its use, once the benefits do not outweigh the risks. |
| format | Article |
| id | doaj-art-32d3764a18e049c5a35db15a4f07ad28 |
| institution | Kabale University |
| issn | 2175-9790 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Universidade de São Paulo |
| record_format | Article |
| series | Brazilian Journal of Pharmaceutical Sciences |
| spelling | doaj-art-32d3764a18e049c5a35db15a4f07ad282025-01-21T07:42:17ZengUniversidade de São PauloBrazilian Journal of Pharmaceutical Sciences2175-97902025-01-016110.1590/s2175-97902025e24177Medicines for the management of overweight and obesity: A systematic review with network meta-analysisGabriela Masiero Marconhttps://orcid.org/0000-0001-6264-888XJhonatan Mendes Paivahttps://orcid.org/0009-0009-3010-6547Mariana Delariva Sakiyamahttps://orcid.org/0009-0006-6706-4529Fernanda Stumpf Toninhttps://orcid.org/0000-0003-4262-8608Fernando Fernandez-Llimoshttps://orcid.org/0000-0002-8529-9595Suzane Virtuosohttps://orcid.org/0000-0002-0957-6431Andreia Cristina Conegero Sancheshttps://orcid.org/0000-0002-3108-7300Abstract To synthesize the evidence about pharmacologic treatment of obesity and overweight and to define the options with the best risk-benefit using the stochastic analysis of multicriteria acceptability (SMAA). The analysis addresses a systematic review (PROSPERO CRD42023423308) whose research was realized in PubMed, Scopus, and Web of Science. Randomized controlled trials were included, which verified the effects of sibutramine, orlistat, liraglutide, and semaglutide in patients with IMC ≥ 26 Kg/ m². The risk of bias analysis was performed with RoB 2.0 and the outcomes evaluated were weight loss and serious adverse events. A total of 102 studies with 45.047 participants were included. The network meta-analysis revealed that all the treatments were significantly more effective than the placebo in weight reduction. The use of semaglutide (especially 0.4 mg/day) was associated with a bigger weight loss in comparison to all the other treatments (p<0.05) and the analysis of SMAA showed a risk-benefit of 95%. Besides that, we suggest re-evaluating of sibutramine 10mg/day as a therapeutic option for patients without hypertension or cardiovascular diseases, and we demonstrate the modest weight loss promoted by orlistat 120mg, sibutramine 5mg, and liraglutide 1,8mg and advise against its use, once the benefits do not outweigh the risks.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1984-82502025000100804&lng=en&tlng=enWeight lossAdverse eventsRisk-benefitPharmacological treatmentObesity |
| spellingShingle | Gabriela Masiero Marcon Jhonatan Mendes Paiva Mariana Delariva Sakiyama Fernanda Stumpf Tonin Fernando Fernandez-Llimos Suzane Virtuoso Andreia Cristina Conegero Sanches Medicines for the management of overweight and obesity: A systematic review with network meta-analysis Brazilian Journal of Pharmaceutical Sciences Weight loss Adverse events Risk-benefit Pharmacological treatment Obesity |
| title | Medicines for the management of overweight and obesity: A systematic review with network meta-analysis |
| title_full | Medicines for the management of overweight and obesity: A systematic review with network meta-analysis |
| title_fullStr | Medicines for the management of overweight and obesity: A systematic review with network meta-analysis |
| title_full_unstemmed | Medicines for the management of overweight and obesity: A systematic review with network meta-analysis |
| title_short | Medicines for the management of overweight and obesity: A systematic review with network meta-analysis |
| title_sort | medicines for the management of overweight and obesity a systematic review with network meta analysis |
| topic | Weight loss Adverse events Risk-benefit Pharmacological treatment Obesity |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1984-82502025000100804&lng=en&tlng=en |
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