关于 GLP-1 受体激动剂在减轻精神药物相关体重增加方面疗效的系统性综述。

IF 3.4 3区 医学 Q2 CLINICAL NEUROLOGY
Trisha Menon, Serene Lee, Xuan Yi Gong, Sabrina Wong, Gia Han Le, Angela T H Kwan, Kayla M Teopiz, Roger Ho, Bing Cao, Taeho Greg Rhee, Yang Jing Zheng, Kyle Valentino, Kangguang Lin, Maj Vinberg, Heidi K Y Lo, Roger S McIntyre
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引用次数: 0

摘要

目的:许多精神药物都与体重增加密切相关。胰高血糖素样肽-1 受体激动剂(GLP-1RAs)是公认的抗肥胖和降糖药物。初步证据还表明,它们适用于减轻精神药物相关体重增加(PDWG)。本系统综述旨在综合来自随机对照试验(RCT)的现有证据,说明 GLP-1RA 对 PDWG 患者体重变化的影响:搜索在线数据库(即 PubMed、OVID Medline 和 Google Scholar),以确定从开始到 2024 年 1 月 1 日的相关研究。由三位独立审稿人根据纳入和排除标准对文章的标题、摘要和全文进行筛选:我们确定了六项参与者年龄≥18 岁(n=374)的研究符合纳入系统综述的条件。大多数研究报告称,GLP-1RA 对人体测量学和/或新陈代谢有明显且有临床意义的影响。所有研究都重复了 GLP-1RAs 的适度或更大作用;研究最多的药物是利拉鲁肽和艾塞那肽。没有足够的文献进行荟萃分析:有证据表明,GLP-1RA 可有效减轻精神科处方药患者的体重增加。据推测,GLP-1RAs 可通过直接影响新陈代谢和与饥饿/焦虑有关的认知过程来减缓精神科处方药患者的体重变化。未来的研究应旨在探索各种 GLP-1RAs 在治疗和预防精神病患者体重异常和代谢平衡异常方面的长期安全性、耐受性和疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A systematic review on the efficacy of GLP-1 receptor agonists in mitigating psychotropic drug-related weight gain.

Objective: Many psychotropic drugs are highly associated with related weight gain. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are established anti-obesity and glucose-lowering agents. Preliminary evidence also indicates they are fit for purpose in mitigating psychotropic drug-related weight gain (PDWG). This systematic review aims to synthesize the extant evidence from randomized controlled trials (RCTs) on the effects of GLP-1RAs on weight change in persons experiencing PDWG.

Methods: Online databases (ie, PubMed, OVID Medline, Google Scholar) were searched to identify relevant studies from inception to January 1, 2024. Articles were screened by title, abstract, and full-text by three independent reviewers against inclusion and exclusion criteria.

Results: We identified six studies with participants aged ≥18 (n=374) that were eligible for inclusion in our systematic review. Most studies reported a significant and clinically meaningful effect of GLP-1RAs on anthropometrics and/or metabolics. All RCTs replicated the finding of modest or greater effects of GLP-1RAs; the most studied agents were liraglutide and exenatide. There was insufficient literature to conduct a meta-analysis.

Conclusion: Evidence suggests that GLP-1RAs are effective in mitigating weight gain in persons prescribed psychiatric medication. It is hypothesized that GLP-1RAs may moderate weight change in persons prescribed psychiatric medication through direct effects on metabolism and cognitive processes implicated in hunger/satiety. Future studies should aim to explore the long-term safety, tolerability, and efficacy profiles of various GLP-1RAs in the treatment and prevention of abnormal weight and metabolic homeostasis in psychiatric populations.

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来源期刊
CNS Spectrums
CNS Spectrums 医学-精神病学
CiteScore
6.20
自引率
6.10%
发文量
239
审稿时长
>12 weeks
期刊介绍: CNS Spectrums covers all aspects of the clinical neurosciences, neurotherapeutics, and neuropsychopharmacology, particularly those pertinent to the clinician and clinical investigator. The journal features focused, in-depth reviews, perspectives, and original research articles. New therapeutics of all types in psychiatry, mental health, and neurology are emphasized, especially first in man studies, proof of concept studies, and translational basic neuroscience studies. Subject coverage spans the full spectrum of neuropsychiatry, focusing on those crossing traditional boundaries between neurology and psychiatry.
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