Glucagon-like peptide agonists for weight management in antipsychotic-induced weight gain: A systematic review and meta-analysis

IF 5.3 2区医学 Q1 PSYCHIATRY

Acta Psychiatrica Scandinavica Pub Date : 2024-07-24 DOI:10.1111/acps.13734

Maarten Bak, Bea Campforts, Patrick Domen, Therese van Amelsvoort, Marjan Drukker

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引用次数: 0

Abstract

Introduction

Managing body weight in patients with antipsychotic-induced weight gain (AIWG) is challenging. Besides lifestyle interventions, pharmacological interventions may contribute to weight loss. This systematic review and meta-analysis evaluated the effect on weight loss and adverse effects of glucagon-like peptide-1 (GLP-1) agonists in patients with AIWG.

Materials and Methods

Following PRISMA guidelines, we performed a meta-analysis of blinded and open-label randomised controlled trials (RCTs), non-randomised controlled trials and cohort studies that evaluated treatment with GLP-1 in patients with AIWG, regardless of psychiatric diagnosis. PubMed, Embase, PsycINFO and Cochrane Library databases were searched. Primary outcome measures were changes in body weight and BMI. Secondary outcomes were changes in adverse effects and severity of psychopathology due to GLP-1 agonists.

Results

Only data for exenatide and liraglutide could be included, that is, five RCTs and one cohort study. For exenatide the mean weight loss was −2.48 kg (95% Confidence Interval (CI) −5.12 to +0.64; p = 0.07), for liraglutide the mean weight loss was −4.70 kg (95% CI −4.85 to −4.56; p < 0.001). The mean change in BMI was −0.82 (95% CI −1.56 to −0.09; p = 0.03) in the exenatide groups and −1.52 (95% CI −1.83 to −1.22; p < 0.001) in the liraglutide groups. Exenatide and liraglutide did not adversely affect psychopathology. The most common adverse events were nausea, vomiting, and diarrhoea.

Conclusion

The GLP-1 agonists exenatide and liraglutide are promising drugs for inducing weight loss in patients with AIWG. The adverse effects are acceptable, and the addition of GLP-1 does not increase the severity of psychopathology. However, more research is needed.

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胰高血糖素样肽激动剂用于控制抗精神病药物引起的体重增加：系统回顾和荟萃分析。

导言：控制抗精神病药物诱发体重增加（AIWG）患者的体重具有挑战性。除了生活方式干预外，药物干预也有助于减轻体重。本系统综述和荟萃分析评估了胰高血糖素样肽-1（GLP-1）激动剂对 AIWG 患者体重减轻的效果和不良反应：根据PRISMA指南，我们对盲法和开放标签的随机对照试验（RCT）、非随机对照试验和队列研究进行了荟萃分析，这些研究评估了GLP-1对AIWG患者的治疗效果，无论其是否患有精神疾病。检索了 PubMed、Embase、PsycINFO 和 Cochrane Library 等数据库。主要结果指标为体重和体重指数的变化。次要结果是 GLP-1 激动剂引起的不良反应和精神病理学严重程度的变化：结果：只纳入了艾塞那肽和利拉鲁肽的数据，即 5 项研究性临床试验和 1 项队列研究。艾塞那肽的平均体重减轻了-2.48千克（95% 置信区间（CI）-5.12至+0.64；P = 0.07），利拉鲁肽的平均体重减轻了-4.70千克（95% CI -4.85至-4.56；P 结论：GLP-1激动剂艾塞那肽和利拉鲁肽是诱导AIWG患者减轻体重的有效药物。其不良反应是可以接受的，而且添加 GLP-1 不会增加精神病理学的严重程度。然而，还需要进行更多的研究。

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

Acta Psychiatrica Scandinavica 医学-精神病学

CiteScore

11.20

自引率

3.00%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.