Incretin Analogs for Weight Management in Adults Without Diabetes.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
liraglutide | decrease | weight loss | adults without diabetes | 5.7% to 11.8% | Percent weight loss ranged from 5.7% to 11.8% | #1 |
semaglutide | decrease | weight loss | adults without diabetes | 14.9% to 17.4% | Percent weight loss ranged from 14.9% to 17.4% | #2 |
tirzepatide | decrease | weight loss | adults without diabetes | 15% to 20.9% | Percent weight loss ranged from 15% to 20.9% | #3 |
liraglutide, semaglutide, and tirzepatide | decrease | weight management | adults without diabetes | - | Efficacy data supporting the use of these agents for weight management were promising | #4 |
liraglutide, semaglutide, and tirzepatide | increase | gastrointestinal adverse effects | adults without diabetes | most common | Safety data were relatively similar across all trials and identified gastrointestinal adverse effects as most common | #5 |
Glucagon-like peptide 1 agonists | neutral | - | overweight or obese patients | - | are preferred for overweight or obese patients | #6 |
All incretin analogs in this review | decrease | weight management | adults without diabetes | - | are superior to placebo | #7 |
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.