Deep Dutta, Radhika Jindal, Nishant Raizada, Lakshmi Nagendra, Hasan Abm Kamrul, Meha Sharma
{"title":"胰高血糖素样肽-1受体激动剂治疗阻塞性睡眠呼吸暂停的疗效和安全性：系统综述和荟萃分析。","authors":"Deep Dutta, Radhika Jindal, Nishant Raizada, Lakshmi Nagendra, Hasan Abm Kamrul, Meha Sharma","doi":"10.4103/ijem.ijem_365_24","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The exponential increase in obesity is responsible for the increased prevalence of obstructive sleep apnoea (OSA). Weight loss is critical to improvement in OSA. Glucagon-like peptide-1 receptor (GLP1R) agonism-based therapies (GLP1RA-BT) have been associated with significant weight loss. Several randomized controlled trials have been published evaluating the use of GLP1RA-BT on OSA. However, the literature review revealed that no systematic review and meta-analysis (SRM) has been published evaluating the efficacy and safety of GLP1RA-BT in OSA.</p><p><strong>Methods: </strong>Electronic databases were searched for studies documenting the use of GLP1RA-BT in OSA. The primary outcome was to evaluate the impact on the apnea-hypopnea index (AHI). Secondary outcomes were to evaluate the impact on percent change in AHI, Epworth Sleepiness Score, body weight, blood pressure, and side-effect profile.</p><p><strong>Results: </strong>From initially screened 59 articles, data from 4 articles having 5 different randomized cohorts (937 patients) were analysed in this SRM. Use of GLP1RA-BT was associated with a significant reduction in AHI [MD-12.50 events/ hour (95% CI:-17.33 - -7.67); <i>P</i> < 0.001; I<sup>2</sup>=95%], percent-reduction in AHI [MD-52.17% (95% CI: -64.49 - -39.85); <i>P</i> < 0.001; I<sup>2</sup> = 0%], percent-reduction in body-weight [MD-12.46% (95% CI:-22.54 - -2.39); <i>P</i> < 0.001; I<sup>2</sup> = 99%] and systolic blood-pressure [MD -4.59 mm of Hg (95% CI:-6.61 - -2.58); P < 0.001; I<sup>2</sup> = 67%]. The considerable heterogeneity was because of greater improvement in outcomes withtirzepatide compared to liraglutide. The occurrence of nausea [RR4.23 (95% CI: 2.73-6.55); <i>P</i> < 0.001; I<sup>2</sup> = 0%], vomiting [RR4.22 (95% CI: 2.12-8.41); <i>P</i> < 0.001; I<sup>2</sup> = 0%], diarrhoea [RR2.81 (95% CI: 1.84-4.31); <i>P</i> < 0.001; I<sup>2</sup> = 0%], and constipation [RR4.51 (95% CI: 2.47-8.26); <i>P</i> < 0.001; I<sup>2</sup> = 0%] were significantly higher with GLP1RA-BT compared to placebo.</p><p><strong>Conclusion: </strong>This SRM provides encouraging data on the use of GLP1RA-BT in improving different respiratory aspects of OSA and reducing body weight and blood pressure.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"29 1","pages":"4-12"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964357/pdf/","citationCount":"0","resultStr":"{\"title\":\"Efficacy and Safety of Glucagon Like Peptide-1 Receptor Agonism Based Therapies in Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis.\",\"authors\":\"Deep Dutta, Radhika Jindal, Nishant Raizada, Lakshmi Nagendra, Hasan Abm Kamrul, Meha Sharma\",\"doi\":\"10.4103/ijem.ijem_365_24\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The exponential increase in obesity is responsible for the increased prevalence of obstructive sleep apnoea (OSA). Weight loss is critical to improvement in OSA. Glucagon-like peptide-1 receptor (GLP1R) agonism-based therapies (GLP1RA-BT) have been associated with significant weight loss. Several randomized controlled trials have been published evaluating the use of GLP1RA-BT on OSA. However, the literature review revealed that no systematic review and meta-analysis (SRM) has been published evaluating the efficacy and safety of GLP1RA-BT in OSA.</p><p><strong>Methods: </strong>Electronic databases were searched for studies documenting the use of GLP1RA-BT in OSA. The primary outcome was to evaluate the impact on the apnea-hypopnea index (AHI). Secondary outcomes were to evaluate the impact on percent change in AHI, Epworth Sleepiness Score, body weight, blood pressure, and side-effect profile.</p><p><strong>Results: </strong>From initially screened 59 articles, data from 4 articles having 5 different randomized cohorts (937 patients) were analysed in this SRM. Use of GLP1RA-BT was associated with a significant reduction in AHI [MD-12.50 events/ hour (95% CI:-17.33 - -7.67); <i>P</i> < 0.001; I<sup>2</sup>=95%], percent-reduction in AHI [MD-52.17% (95% CI: -64.49 - -39.85); <i>P</i> < 0.001; I<sup>2</sup> = 0%], percent-reduction in body-weight [MD-12.46% (95% CI:-22.54 - -2.39); <i>P</i> < 0.001; I<sup>2</sup> = 99%] and systolic blood-pressure [MD -4.59 mm of Hg (95% CI:-6.61 - -2.58); P < 0.001; I<sup>2</sup> = 67%]. The considerable heterogeneity was because of greater improvement in outcomes withtirzepatide compared to liraglutide. The occurrence of nausea [RR4.23 (95% CI: 2.73-6.55); <i>P</i> < 0.001; I<sup>2</sup> = 0%], vomiting [RR4.22 (95% CI: 2.12-8.41); <i>P</i> < 0.001; I<sup>2</sup> = 0%], diarrhoea [RR2.81 (95% CI: 1.84-4.31); <i>P</i> < 0.001; I<sup>2</sup> = 0%], and constipation [RR4.51 (95% CI: 2.47-8.26); <i>P</i> < 0.001; I<sup>2</sup> = 0%] were significantly higher with GLP1RA-BT compared to placebo.</p><p><strong>Conclusion: </strong>This SRM provides encouraging data on the use of GLP1RA-BT in improving different respiratory aspects of OSA and reducing body weight and blood pressure.</p>\",\"PeriodicalId\":13353,\"journal\":{\"name\":\"Indian Journal of Endocrinology and Metabolism\",\"volume\":\"29 1\",\"pages\":\"4-12\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964357/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Endocrinology and Metabolism\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/ijem.ijem_365_24\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/2/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Endocrinology and Metabolism","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/ijem.ijem_365_24","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/28 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
Efficacy and Safety of Glucagon Like Peptide-1 Receptor Agonism Based Therapies in Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis.
Introduction: The exponential increase in obesity is responsible for the increased prevalence of obstructive sleep apnoea (OSA). Weight loss is critical to improvement in OSA. Glucagon-like peptide-1 receptor (GLP1R) agonism-based therapies (GLP1RA-BT) have been associated with significant weight loss. Several randomized controlled trials have been published evaluating the use of GLP1RA-BT on OSA. However, the literature review revealed that no systematic review and meta-analysis (SRM) has been published evaluating the efficacy and safety of GLP1RA-BT in OSA.
Methods: Electronic databases were searched for studies documenting the use of GLP1RA-BT in OSA. The primary outcome was to evaluate the impact on the apnea-hypopnea index (AHI). Secondary outcomes were to evaluate the impact on percent change in AHI, Epworth Sleepiness Score, body weight, blood pressure, and side-effect profile.
Results: From initially screened 59 articles, data from 4 articles having 5 different randomized cohorts (937 patients) were analysed in this SRM. Use of GLP1RA-BT was associated with a significant reduction in AHI [MD-12.50 events/ hour (95% CI:-17.33 - -7.67); P < 0.001; I2=95%], percent-reduction in AHI [MD-52.17% (95% CI: -64.49 - -39.85); P < 0.001; I2 = 0%], percent-reduction in body-weight [MD-12.46% (95% CI:-22.54 - -2.39); P < 0.001; I2 = 99%] and systolic blood-pressure [MD -4.59 mm of Hg (95% CI:-6.61 - -2.58); P < 0.001; I2 = 67%]. The considerable heterogeneity was because of greater improvement in outcomes withtirzepatide compared to liraglutide. The occurrence of nausea [RR4.23 (95% CI: 2.73-6.55); P < 0.001; I2 = 0%], vomiting [RR4.22 (95% CI: 2.12-8.41); P < 0.001; I2 = 0%], diarrhoea [RR2.81 (95% CI: 1.84-4.31); P < 0.001; I2 = 0%], and constipation [RR4.51 (95% CI: 2.47-8.26); P < 0.001; I2 = 0%] were significantly higher with GLP1RA-BT compared to placebo.
Conclusion: This SRM provides encouraging data on the use of GLP1RA-BT in improving different respiratory aspects of OSA and reducing body weight and blood pressure.
期刊介绍：
The Indian Journal of Endocrinology and Metabolism (IJEM) aims to function as the global face of Indian endocrinology research. It aims to act as a bridge between global and national advances in this field. The journal publishes thought-provoking editorials, comprehensive reviews, cutting-edge original research, focused brief communications and insightful letters to editor. The journal encourages authors to submit articles addressing aspects of science related to Endocrinology and Metabolism in particular Diabetology. Articles related to Clinical and Tropical endocrinology are especially encouraged. Sub-topic based Supplements are published regularly. This allows the journal to highlight issues relevant to Endocrine practitioners working in India as well as other countries. IJEM is free access in the true sense of the word, (it charges neither authors nor readers) and this enhances its global appeal.
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