Comparison of pharmacotherapies for obesity with sleeve gastrectomy: a network meta-analysis and systematic review.

IF 2.9 Q3 ENDOCRINOLOGY & METABOLISM

Expert Review of Endocrinology & Metabolism Pub Date : 2026-05-01 Epub Date: 2026-04-12 DOI:10.1080/17446651.2026.2656247

Zachary Omeh, Tahira Khan, Olalekan Uthman, Thomas M Barber

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引用次数: 0

Abstract

Introduction: Tirzepatide, a glucagon-like peptide-1 receptor agonist (GLP1RA) and glucose-dependent insulinotropic-peptide (GIP), has shown efficacy regarding weight-loss.

Methods: Systematic review and network meta-analysis of randomized controlled trials. MEDLINE, EMBASE, and Cochrane CENTRAL databases were searched between 2014 and 2024 for trials comparing sleeve gastrectomy (SG), Tirzepatide and other pharmacotherapies to control or each other. Eligible studies: adults with obesity and weight loss outcomes ≥24 weeks. Primary outcome: percentage change total body weight. Secondary outcomes included adverse events. Pairwise and network meta-analyses were performed. Interventions ranked by: P-score, mean difference (MD), 95% confidence intervals (CI).

Results: Data from 23 trials (14,293 participants) were analyzed. SG (MD 21.1% TWL, 95% CI 14.2% to 28.0%) and Tirzepatide 10 or 15 mg (MD 21.3% TWL, 95% CI 17.3% to 25.2%) demonstrated statistically equivalent weight-loss efficacy (P-score: 0.84) and had the most favorable effectiveness profiles. Semaglutide 2.4 mg (MD 12.7% TWL) and Liraglutide 3.0 mg (MD 5.1% TWL) showed moderate efficacy, whilst Orlistat showed minimal effect (MD 2.7% TWL, 95% CI -4.2% to 9.6%). Network meta-analysis of adverse events demonstrated that Semaglutide 2.4 mg and Orlistat had the most favorable safety profiles amongst pharmacotherapies.

Conclusions: Tirzepatide 10 mg and 15 mg is equivalent to SG regarding weight-loss efficacy.

Registration: This paper was registered with PROSPERO (ID: CRD420251016726). Due to institutional academic requirements and checks, registration was completed after the review began, however the review protocol (supplement material S1) was developed prior to the review, provided by the authors, and thoroughly adhered to by the authors.

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肥胖症药物治疗与袖式胃切除术的比较：网络荟萃分析和系统评价。

tizepatide是一种胰高血糖素样肽-1受体激动剂（GLP1RA）和葡萄糖依赖性胰岛素肽（GIP），具有减肥功效。方法：采用随机对照试验进行系统评价和网络荟萃分析。在MEDLINE、EMBASE和Cochrane CENTRAL数据库中检索了2014年至2024年间比较袖式胃切除术（SG）、替西帕肽和其他药物治疗相互对照或相互对照的试验。符合条件的研究：肥胖且体重减轻结果≥24周的成年人。主要结局：总体重变化百分比。次要结局包括不良事件。进行了两两和网络荟萃分析。干预措施的排名：P-score、mean difference （MD）、95% confidence intervals （CI）。结果：分析了23项试验（14293名受试者）的数据。SG （MD 21.1% TWL, 95% CI 14.2%至28.0%）和替西帕肽10或15 mg （MD 21.3% TWL, 95% CI 17.3%至25.2%）表现出统计学上相同的减肥疗效（p值：0.84），并且具有最有利的疗效。Semaglutide 2.4 mg （MD 12.7% TWL）和Liraglutide 3.0 mg （MD 5.1% TWL）显示中等疗效，而奥利司他显示最小疗效（MD 2.7% TWL, 95% CI -4.2%至9.6%）。不良事件的网络荟萃分析表明，Semaglutide 2.4 mg和奥利司他在药物治疗中具有最有利的安全性。结论：替西帕肽10mg和15mg的减肥效果与SG相当。注册：本文已注册至PROSPERO （ID: CRD420251016726）。由于机构的学术要求和检查，注册是在评审开始后完成的，但评审方案（补充材料S1）是在评审之前制定的，由作者提供，并由作者彻底遵守。

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来源期刊

Expert Review of Endocrinology & Metabolism ENDOCRINOLOGY & METABOLISM-

CiteScore

4.80

自引率

0.00%

发文量

期刊介绍： Implicated in a plethora of regulatory dysfunctions involving growth and development, metabolism, electrolyte balances and reproduction, endocrine disruption is one of the highest priority research topics in the world. As a result, we are now in a position to better detect, characterize and overcome the damage mediated by adverse interaction with the endocrine system. Expert Review of Endocrinology and Metabolism (ISSN 1744-6651), provides extensive coverage of state-of-the-art research and clinical advancements in the field of endocrine control and metabolism, with a focus on screening, prevention, diagnostics, existing and novel therapeutics, as well as related molecular genetics, pathophysiology and epidemiology.