Eficácia de intervenções farmacológicas na redução de massa corporal em adultos com sobrepeso e obesidade: uma revisão sistemática com meta-análise

Abstract

According to the World Health Organization (WHO), in 2016, more than 1.9 billion adults, aged 18 and over, were overweight, 650 million of whom were obese. Thus, efficient treatment strategies are necessary to control these conditions, with drug therapy being indicated in some cases. In the literature, there is a lack of studies that compare the efficacy of different types of drugs in the treatment of obesity. Therefore, this systematic review with meta-analysis aimed to compare the efficacy of different pharmacological treatments on the reduction of body mass and the adverse effects on overweight and obesity, namely: orlistat, sibutramine, liraglutide, semagglutide, phentermine-topiramate and naltrexone- bupropion. A search for studies was carried out in the NCBI Pubmed / Medline Pubmed, Embase and Scopus databases, including randomized controlled clinical trials (RCT). Studies published between 2010 and August 2020 were selected, with a follow-up period greater than or equal to one year, participants ≥18 years and with a body mass index ≥25 kg/m². Fourteen randomized, double-blind, placebo-controlled clinical trials were included, totaling 15,447 participants. Data from studies of observed incidence of at least 5% weight reduction with treatments and placebo were grouped. The meta-analysis demonstrated a greater chance of losing at least 5% of weight in patients who used liraglutide compared to placebo, with an odds ratio of 2.60 (95% confidence interval, 1.26-5, 42; P <0.05). Regarding adverse effects, pharmacological interventions showed higher rates of gastrointestinal tract events compared to placebo. Finally, although liraglutide has shown statistically significant results for greater reduction in body mass, further studies are needed to define drug associations with weight loss.