HealthDay News — Treatment with one class of diabetes drugs, glucagon-like peptide-1 receptor (GLP-1R) agonists, helped obese and overweight patients with and without type 2 diabetes lose weight, data indicates.
All patients who were administered GLP-1 agonists that were included in a review and metanalysis achieved an average 6.4 lbs greater weight loss than patients on placebo or other diabetes drugs, Tina Vilsbøll, MD, of the University of Copenhagen in Denmark, and colleagues reported online in BMJ.
“Our results suggest that treatment with GLP-1 agonists is an effective intervention for participants who are overweight, irrespective of whether they have diabetes,” the researchers wrote.
They reviewed 21 randomized, controlled trials that included 6,411 adults with BMIs ≥25 kg/m², with and without type 2 diabetes. Participants were administered either exenatide (Byetta) twice daily, exenatide once weekly or liraglutide (Victoza) once daily at clinically relevant doses for at least 20 weeks. Controls received either placebo, oral anti-diabetic drugs or insulin.
GLP-1R agonist groups achieved greater weight loss than the control groups (weighted mean difference, −2.9 kg; 95% CI: −3.6 to −2.2), with subgroup analysis revealing greater weight loss among those on the highest doses. There were no differences in weight loss between those on liraglutide and those on exenatide at various doses, the researchers reported.
Beneficial effects of GLP-1R agonists were observed for systolic and diastolic BP, plasma cholesterol concentrations and glycemic control, but there were no significant effects for plasma liver enzyme concentrations.
There was evidence of intertrial heterogeneity, but in regression analyses, no evidence of bias or small study effects was found.
Drug side effects included nausea, diarrhea and vomiting, the researchers warned. They cautioned that more research is needed on cardiovascular disease comorbidities before GLP-1R agonists can be recommended for weight loss.
In an accompanying editorial, Raj Padwal, MD, of Mackenzie Health Sciences Center in Edmonton, Canada, warned that the findings are too preliminary to change clinical practice and cautioned about the potential risk for pancreatitis, pancreatic cancer and thyroid C-cell tumors with this class of drugs.
“[O]ff-label use of GLP-1 agonists for weight loss in people without diabetes cannot be recommended at this time,” Padwal wrote.