Efficacy and safety of once-weekly subcutaneous semaglutide in adults with overweight or obesity: systematic review with meta-analysis

Gilson Dorneles; Ellen Algeri; Gerhard Lauterbach; Marcelo Pereira; Brigida Fernandes

doi:10.1055/a-2303-8558

Efficacy and safety of once-weekly subcutaneous semaglutide in adults with overweight or obesity: systematic review with meta-analysis

Exp Clin Endocrinol Diabetes. 2024 Apr 10. doi: 10.1055/a-2303-8558. Online ahead of print.

Authors

Gilson Dorneles¹, Ellen Algeri², Gerhard Lauterbach³, Marcelo Pereira⁴, Brigida Fernandes⁵

Affiliations

¹ UFCSPA, Porto Alegre, Brazil.
² Núcleo de Avaliação de Tecnologias em Saúde, Universidade Federal da Grande Dourados, Dourados, Brazil.
³ Núcleo de Avaliação de Tecnologias em Saúde - Hospital Universitário da Universidade Federal de São Carlos, Universidade Federal de São Carlos, Sao Carlos, Brazil.
⁴ Centro de Informação Sobre Medicamentos, Secretaria da Saúde do Estado da Bahia, Salvador, Brazil.
⁵ Capixaba Institute for Health Teaching Research and Innovation, Vitoria, Brazil.

PMID: 38599612
DOI: 10.1055/a-2303-8558

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 accessed 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. We conducted a random-effects meta-analysis.

Results: We included ten publications with 22.155 patients. 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 - 1.62; CoE: Low), but increases in the risk to discontinued treatment (RR: 2.03; 95%CI: 1.87 - 2.20; CoE: High) and gastrointestinal adverse events (RR: 3.26; 95%CI: 1.99 - 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 to treat obesity.