Semaglutide effects on safety and cardiovascular outcomes in patients with overweight or obesity: a systematic review and meta-analysis.

IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM International Journal of Obesity Pub Date : 2024-10-12 DOI:10.1038/s41366-024-01646-9
André Saad Cleto, João Matheus Schirlo, Mayara Beltrame, Victor Hugo Oliveira Gomes, Isabela Hellmann Acras, Guinter Sponholz Neiverth, Breno Bach Silva, Beatriz Moreira Salles Juliatto, Janete Machozeki, Camila Marinelli Martins
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Abstract

Background: Semaglutide is a GLP-1 receptor agonist that provides a reduction in glycated hemoglobin and weight. The objective was to evaluate whether the use of semaglutide, in individuals with overweight or obesity, reduces cardiovascular outcomes and adverse effects (AE).

Methods: The data bases Pubmed, Lilacs, Scielo, Scopus, Web of Science and Cochrane Library were surveyed.

Results: Initially, 3333 articles were found, of which 19 articles were included. An additional search included 19 studies, totaling 38 articles. Relative risk (RR) values were significant for hospitalization due to heart failure (HF) 0.24 95% CI 0.12-0.57 (n = 2; 1045 participants; I² = 0.18), death due to cardiovascular causes 0.83 95% CI 0.71-0.98 (n = 3; 24 084 participants; I² = 0.21), death from any cause 0.79 95% CI 0.70-0.89 (n = 3; 24 084 participants; I² = 0.07), coronary revascularization 0.76 95% CI 0.69-0.85 (n = 2;20 951 participants; I² = 0.41), and non-fatal myocardial infarction 0.76 95%CI 0.66-0.88 (n = 3; 24 084 participants; I² = 0.21), with a difference between the subgroups (p = 0.05), favoring the subcutaneous administration route. The RR of stroke was 0.65 95% CI 0.44-0.97 for patients with diabetes (n = 2; 6480 participants; I² = 0.66). There was no difference between the frequency of constipation and routes of administration, as well as between doses of oral semaglutide. The RR of adverse effects was only not significant for discontinuation of treatment for oral semaglutide.

Conclusion: The use of semaglutide reduced 76% in hospitalization due to HF, 17% deaths due to cardiovascular causes, 21% deaths due to any cause, 24% non-fatal myocardial infarction, 24% coronary revascularization and 35% stroke (in patients with diabetes). The use of semaglutide was associated with a higher relative risk and frequency of most adverse effects evaluated.

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塞马鲁肽对超重或肥胖患者的安全性和心血管后果的影响:系统综述和荟萃分析。
背景塞马鲁肽是一种GLP-1受体激动剂,可降低糖化血红蛋白和体重。研究目的是评估超重或肥胖症患者使用塞马鲁肽是否会减少心血管后果和不良反应(AE):方法:调查了 Pubmed、Lilacs、Scielo、Scopus、Web of Science 和 Cochrane Library 等数据库:结果:初步检索到 3333 篇文章,其中 19 篇被收录。额外的搜索包括 19 项研究,共计 38 篇文章。相对风险(RR)值显著的有:心力衰竭(HF)导致的住院治疗 0.24 95% CI 0.12-0.57 (n = 2; 1045 名参与者;I² = 0.18)、心血管原因导致的死亡 0.83 95% CI 0.71-0.98 (n = 3; 24 084 名参与者;I² = 0.21)、任何原因导致的死亡 0.79 95% CI 0.70-0.89 (n = 3; 24 084 名参与者;I² = 0.亚组间存在差异(P = 0.05),皮下注射途径更优。糖尿病患者中风的 RR 为 0.65 95% CI 0.44-0.97(n = 2;6480 名参与者;I² = 0.66)。便秘频率与给药途径以及口服塞马鲁肽的剂量之间没有差异。只有口服塞马鲁肽中断治疗的不良反应发生率不显著:结论:在糖尿病患者中,使用塞马鲁肽可减少76%因高血压住院治疗、17%因心血管原因死亡、21%因任何原因死亡、24%非致命性心肌梗死、24%冠状动脉血运重建和35%中风。使用semaglutide与大多数不良反应的相对风险和频率较高有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International Journal of Obesity
International Journal of Obesity 医学-内分泌学与代谢
CiteScore
10.00
自引率
2.00%
发文量
221
审稿时长
3 months
期刊介绍: The International Journal of Obesity is a multi-disciplinary forum for research describing basic, clinical and applied studies in biochemistry, physiology, genetics and nutrition, molecular, metabolic, psychological and epidemiological aspects of obesity and related disorders. We publish a range of content types including original research articles, technical reports, reviews, correspondence and brief communications that elaborate on significant advances in the field and cover topical issues.
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