Abstract
Background To evaluate the efficacy and safety of once-weekly subcutaneous
semaglutide treatment in overweight or obese patients without type 2
diabetes.
Methods Randomized clinical trials that assessed the impact of once-weekly
semaglutide on body weight and safety outcomes in overweight or obese patients
were retrieved from PubMed, EMBASE, and Lilacs up to November 2023. Risk of bias
was assessed with RoB 2.0, and certainty of evidence (CoE) with GRADE. A
random-effects meta-analysis was conducted.
Results Ten publications, with 22.155 patients, were included. Semaglutide
decreased relative body weight (MD: −11.80; 95%CI: −13.53 to −10.07; CoE: High),
absolute body weight (MD: −11.58; 95%CI: −13.25 to −9.90; CoE: High) and BMI
(MD: −4.15; 95%CI: −4.85 to −3.45; CoE: High). Semaglutide also increased the
proportion of patients who achieved 5%, 10%, and 15% of weight loss ([weight
loss≥5%: RR 2.29, 95% CI: 1.88 to 2.80; CoE: High]; [weight loss≥10%: RR 4.54,
95% CI: 3.45 to 5.98; CoE: High]; [weight loss≥15%: RR 8.29, 95%CI: 5.54 to
12.39; CoE: High]). Semaglutide leads to small risk to adverse events (RR: 1.03;
95%CI: 1 to 1.06; CoE: High), no difference in the serious adverse events (RR:
1.07; 95%CI: 0.70 to 1.62; CoE: Low), but increases in the risk to discontinued
treatment (RR: 2.03; 95%CI: 1.87 to 2.20; CoE: High) and gastrointestinal
adverse events (RR: 3.26; 95%CI: 1.99 to 5.34; CoE: Moderate).
Conclusion This up-to-date systematic review highlights that once-weekly
semaglutide treatment resulted in clinically important weight loss, becoming a
promising adjuvant therapy for obesity.
Keywords
GLP-1 receptor agonist - obesity - weight management - anti-obesity drugs - meta-analysis
