Pharmaceutical Therapies for the Treatment of Obesity: A Network Meta-analysis.
Study Goal
The researchers aimed to compare the effectiveness of various obesity treatments, including supervised walking combined with hydroxycitric acid and a controlled diet, to determine optimal therapeutic options.
Results Summary
Supervised walking combined with hydroxycitric acid and a 2000-kcal/d diet was ranked as the second most effective treatment for obesity in trials involving both men and women, with a high P-score (0.92). The study did not isolate walking's individual effects but highlighted its efficacy in combination therapy.
Population
Adults with obesity (both men and women, women only, and men only).
Effective Dosage
Supervised walking (specific duration/frequency not detailed) combined with hydroxycitric acid, 4667 mg 3 times daily, and a 2000-kcal/d diet.
Duration
Not specified in the abstract.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
semaglutide, 2.4 mg | increase | treatment effectiveness for obesity | both men and women | P-score = 0.99 | best-ranked treatment | #1 |
hydroxycitric acid, 4667 mg 3 times daily, supervised walking, and 2000-kcal/d diet | increase | treatment effectiveness for obesity | both men and women | P-score = 0.92 | best-ranked treatment | #2 |
phentermine hydrochloride and behavioral therapy | increase | treatment effectiveness for obesity | both men and women | P-score = 0.92 | best-ranked treatment | #3 |
liraglutide plus advice to diet and exercise | increase | treatment effectiveness for obesity | both men and women | P-score = 1.00 | best-ranked treatment | #4 |
beloranib | increase | treatment effectiveness for obesity | women | P-score = 0.98 | best-ranked treatment | #5 |
sibutramine, metformin, and hypocaloric diet | increase | treatment effectiveness for obesity | women | P-score = 0.90 | best-ranked treatment | #6 |
- | no change | treatment effectiveness for obesity | men | - | no significant difference among treatments | #7 |
semaglutide | increase | treatment for obesity | both men and women | - | seems to be an effective treatment option | #8 |
beloranib | increase | treatment for obesity and overweight | women | - | appears to be particularly effective | #9 |
PURPOSE: Despite the introduction of various pharmaceutical therapies for treating obesity, selecting the optimal treatment remains challenging for both patients and physicians. Therefore, in this network meta-analysis (NMA), we aim to simultaneously compare the available drugs for treating obesity to determine the most effective treatment options. METHODS: International databases, including PubMed, Web of Science, Scopus, Cochrane Library, and Embase, were searched for studies published from database inception to April 2023. The consistency assumption was evaluated using by the loop-specific and design × treatment interaction approaches. The effects of treatment in the NMA were summarized using mean differences based on a change score analysis. The random-effects model was used to report the results. Results were reported with 95% CIs. FINDINGS: Of 9519 retrieved references, 96 randomized controlled trials, including 68 with both men and women, 23 with women only, and 5 with men only, met the eligibility criteria for this study. There were 4 treatment networks in the trials of both men and women, 4 in the trials of women only, and 1 in the trials of men only. The best-ranked treatments in the network in the trials of both men and women were (1) semaglutide, 2.4 mg (P-score = 0.99); (2) hydroxycitric acid, 4667 mg 3 times daily, supervised walking, and 2000-kcal/d diet (P-score = 0.92); (3) phentermine hydrochloride and behavioral therapy (P-score = 0.92); and (4) liraglutide plus advice to diet and exercise (P-score = 1.00). In women, the best-ranked treatments were beloranib (P-score = 0.98) and sibutramine, metformin, and hypocaloric diet (P-score = 0.90). In men, there was no significant difference among treatments. IMPLICATIONS: According to the results of this NMA, semaglutide seems to be an effective treatment option for both men and women, whereas beloranib appears to be particularly effective for women with obesity and overweight, but its production has been stopped since 2016 and is not available.