SAFETY AND EFFICACY OF GLP-1 RECEPTOR AGONISTS IN PATIENTS WITH ANTIPSYCHOTICS-INDUCED OBESITY: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Author(s)
Monika Sharma, MPH1, Ritika tak, MPH1, BHOLANATH CHOWDHURY, MPH1, Anoop Kumar, PhD1, Manik Chhabra, Post Doc2, Kamre Aalam3.
1Pharmacology, Delhi Pharmaceutical Sciences and Research University, New Delhi, India, 2Department of Epidemiology and Biostatistics, Western University, London, ON, Canada, 3ISF COLLEGE OF PHARMACY, India.
1Pharmacology, Delhi Pharmaceutical Sciences and Research University, New Delhi, India, 2Department of Epidemiology and Biostatistics, Western University, London, ON, Canada, 3ISF COLLEGE OF PHARMACY, India.
OBJECTIVES: To evaluate the safety and efficacy of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in patients with antipsychotic drug-induced obesity.
METHODS: MEDLINE, Embase and the Cochrane Library were searched for randomized controlled trials (RCTs) evaluating GLP-1 RAs in patients with antipsychotic drug-induced obesity. Two independent reviewers performed screening, data extraction, and quality assessment. Risk of bias was assessed using the Cochrane Risk of Bias tool. Efficacy outcomes were pooled using the metacont function, while safety outcomes were analyzed using the metabin function with the Mantel-Haenszel method in R.
RESULTS: Of 57,850 identified citations, 9 unique RCTs involving 625 patients were included, with a median age range of 18-65 years, 50.3% male and 49.7% female participants. Compared with controls, GLP-1 RAs significantly reduced body weight (MD -7.01 kg; 95% CI -10.03 to -3.99; 8 trials), BMI (MD -2.33 kg/m²; 95% CI -3.33 to -1.32; 8 trials), waist circumference (MD -4.47 cm; 95% CI -6.14 to -2.80; 7 trials), and HbA1c (MD -0.34%; 95% CI -0.47 to -0.21; 8 trials). Subgroup analyses showed greater efficacy with semaglutide-containing regimens, particularly for body weight reduction (MD -11.05 kg; 95% CI -14.92 to -7.19), BMI reduction (MD -3.60 kg/m²; 95% CI -4.68 to -2.52), waist circumference reduction (MD -6.33 cm; 95% CI -7.91 to -4.74), and HbA1c reduction (MD -0.44%; 95% CI -0.53 to -0.35). Compared with controls, GLP-1 RAs were associated with significantly increased risks of gastrointestinal adverse events, particularly nausea (RR 1.69; 95% CI 1.26-2.27; 7 trials), vomiting (RR 2.26; 95% CI 1.47-3.46; 7 trials), diarrhea (RR 1.96; 95% CI 1.13-3.40; 7 trials), and abdominal pain (RR 2.01; 95% CI 1.24-3.24; 4 trials).
CONCLUSIONS: GLP-1 receptor agonists significantly improved weight-related and glycemic outcomes in patients with antipsychotic drug-induced obesity with acceptable tolerability.
METHODS: MEDLINE, Embase and the Cochrane Library were searched for randomized controlled trials (RCTs) evaluating GLP-1 RAs in patients with antipsychotic drug-induced obesity. Two independent reviewers performed screening, data extraction, and quality assessment. Risk of bias was assessed using the Cochrane Risk of Bias tool. Efficacy outcomes were pooled using the metacont function, while safety outcomes were analyzed using the metabin function with the Mantel-Haenszel method in R.
RESULTS: Of 57,850 identified citations, 9 unique RCTs involving 625 patients were included, with a median age range of 18-65 years, 50.3% male and 49.7% female participants. Compared with controls, GLP-1 RAs significantly reduced body weight (MD -7.01 kg; 95% CI -10.03 to -3.99; 8 trials), BMI (MD -2.33 kg/m²; 95% CI -3.33 to -1.32; 8 trials), waist circumference (MD -4.47 cm; 95% CI -6.14 to -2.80; 7 trials), and HbA1c (MD -0.34%; 95% CI -0.47 to -0.21; 8 trials). Subgroup analyses showed greater efficacy with semaglutide-containing regimens, particularly for body weight reduction (MD -11.05 kg; 95% CI -14.92 to -7.19), BMI reduction (MD -3.60 kg/m²; 95% CI -4.68 to -2.52), waist circumference reduction (MD -6.33 cm; 95% CI -7.91 to -4.74), and HbA1c reduction (MD -0.44%; 95% CI -0.53 to -0.35). Compared with controls, GLP-1 RAs were associated with significantly increased risks of gastrointestinal adverse events, particularly nausea (RR 1.69; 95% CI 1.26-2.27; 7 trials), vomiting (RR 2.26; 95% CI 1.47-3.46; 7 trials), diarrhea (RR 1.96; 95% CI 1.13-3.40; 7 trials), and abdominal pain (RR 2.01; 95% CI 1.24-3.24; 4 trials).
CONCLUSIONS: GLP-1 receptor agonists significantly improved weight-related and glycemic outcomes in patients with antipsychotic drug-induced obesity with acceptable tolerability.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EPH26
Topic
Epidemiology & Public Health
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)