Incretin Analogs for Weight Management in Adults Without Diabetes

Document Type

Article

Publication Date

7-31-2023

Publication Title

The Annals of pharmacotherapy

Abstract

OBJECTIVE: This is a narrative review of incretin analogs and their effect on weight management in adult without diabetes.

DATA SOURCES: Randomized controlled trials were identified by English language. PubMed/MEDLINE, Scopus, and Embase databases were searched from inception through June 2023 to identify all pertinent trials reporting outcomes on efficacy and safety search using the terms: tirzepatide, semaglutide, liraglutide, and obesity.

STUDY SELECTION AND DATA EXTRACTION: Selected studies were included if the study population was composed of adults without diabetes being treated by glucagon-like peptide 1 (GLP-1) receptor agonists or glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 agonists for weight management, and weight loss was assessed as a primary outcome.

DATA SYNTHESIS: Fifteen studies involving 3 pharmacotherapies (liraglutide, semaglutide, and tirzepatide) were identified. Efficacy data supporting the use of these agents for weight management were promising when compared to placebo and/or other behavioral therapies. Percent weight loss ranged from 5.7% to 11.8%, 14.9% to 17.4%, and 15% to 20.9% for liraglutide, semaglutide, and tirzepatide, respectively. Safety data were relatively similar across all trials and identified gastrointestinal adverse effects as most common.

RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE: Glucagon-like peptide 1 agonists are preferred for overweight or obese patients by the American Gastroenterological Association. Future guidelines may address tirzepatides' place in therapy as new evidence comes forth. Providers should consider patient-specific factors such as cost, adverse effects, drug interactions, and comorbidities when prescribing these agents and provide education regarding the need for concurrent diet and exercise modifications.

CONCLUSIONS: All incretin analogs in this review are superior to placebo when used for weight management in adults without diabetes.

Medical Subject Headings

Adult; Humans; Incretins/adverse effects; Liraglutide/adverse effects; Hypoglycemic Agents/adverse effects; Diabetes Mellitus; Type 2/drug therapy; Gastric Inhibitory Polypeptide/therapeutic use; Obesity/drug therapy/epidemiology; Weight Loss; Glucagon-Like Peptide-1 Receptor Agonists; glucagon-like peptide 1 receptor agonist; glucose-dependent insulinotropic polypeptide receptor agonist; incretin analog; obesity

PubMed ID

37522468

ePublication

ePub ahead of print

Volume

58

Issue

4

First Page

398

Last Page

406

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