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Review
. 2024 May;32(5):840-856.
doi: 10.1002/oby.24002. Epub 2024 Feb 27.

Efficacy and safety of tirzepatide, GLP-1 receptor agonists, and other weight loss drugs in overweight and obesity: a network meta-analysis

Xin-Hui Pan  1 , Bryan Tan  1 , Yip Han Chin  2 , Ethan Cheng Zhe Lee  3 , Gwyneth Kong  2 , Bryan Chong  1 , Martin Kueh  4 , Chin Meng Khoo  1   5 , Anurag Mehta  6 , Priyanka Majety  7 , Gowtham R Grandhi  6 , Georgios K Dimitriadis  8   9 , Roger Foo  1   10 , Nicholas W S Chew  1   10 , Carel W Le Roux  11 , Mamas A Mamas  12   13 , Mark Y Chan  1   10
Affiliations
Review

Efficacy and safety of tirzepatide, GLP-1 receptor agonists, and other weight loss drugs in overweight and obesity: a network meta-analysis

Xin-Hui Pan et al. Obesity (Silver Spring). 2024 May.

Abstract

Objective: This network meta-analysis evaluates the efficacy and safety of tirzepatide compared to glucagon-like peptide-1 receptor agonists (GLP-1 RA) and other weight loss drugs in the treatment of overweight and obesity.

Methods: MEDLINE, Embase, and Cochrane CENTRAL were searched for randomized controlled trials on tirzepatide, GLP-1 RA, and weight loss drugs approved by the US Food and Drug Administration. A network meta-analysis was performed, drawing direct and indirect comparisons between treatment groups. Network diagrams and surface under the cumulative ranking curve analysis were performed for primary (≥5%, ≥10%, ≥15%, absolute weight loss) and secondary outcomes and adverse effects.

Results: Thirty-one randomized controlled trials, involving more than 35,000 patients, were included in this study. Tirzepatide 15 mg ranked in the top three across weight-related parameters, glycemic profile (glycated hemoglobin), lipid parameters (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides), and blood pressure. Tirzepatide 15 mg had the highest efficacy compared with placebo for achieving ≥15% weight loss (risk ratio 10.24, 95% CI: 6.42-16.34). As compared to placebo, tirzepatide and GLP-1 RA across all doses had significant increases in gastrointestinal adverse effects.

Conclusions: The superiority of tirzepatide and GLP-1 RA in inducing weight loss and their ability to target multiple metabolic parameters render them promising candidates in the treatment of patients with overweight and obesity.

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References

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