PMID- 37253796 OWN - NLM STAT- MEDLINE DCOM- 20230724 LR - 20230724 IS - 1476-5497 (Electronic) IS - 0307-0565 (Linking) VI - 47 IP - 8 DP - 2023 Aug TI - Efficacy and safety of tirzepatide for treatment of overweight or obesity. A systematic review and meta-analysis. PG - 677-685 LID - 10.1038/s41366-023-01321-5 [doi] AB - BACKGROUND: Recent studies suggest that tirzepatide, a dual glucose-dependent insulinotropic-peptide (GIP) and glucagon-like peptide-1 receptor agonist (GLP-1 RA), has significant weight loss effects. This systematic review and meta-analysis aims to assess the efficacy and safety of tirzepatide for weight loss in patients with overweight or obesity. METHODS: Medline, Embase and Cochrane CENTRAL were searched for randomized controlled trials (RCTs) on tirzepatide's weight loss efficacy for these patients. A single arm meta-analysis of proportions estimated primary outcomes, >/=5%, >/=10%, and >/=15% weight loss, and adverse events (AEs); while meta-analysis of means estimated secondary outcomes. Comparative meta-analysis was conducted between tirzepatide and control arms where mean differences and odds ratios were estimated for continuous and dichotomous outcomes respectively. RESULTS: RCTs included in this study revealed that among 5800 patients, 78.22% (95% CI: 72.15% to 83.73%), 55.60% (95% CI: 46.54% to 64.47%), 32.28% (95% CI: 23.17% to 42.12%) achieved >/=5%, >/=10%, and >/=15% weight loss, respectively. Tirzepatide 5 mg demonstrated weight loss superiority relative to placebo (MD: -12.47 kg, 95% CI: -13.94 kg to -11.00 kg) and semaglutide (n = 1409, MD: -1.90 kg, 95% CI: -2.97 kg to -0.83 kg) with dose-dependent increase for 10 mg and 15 mg doses. The comparison between tirzepatide and semaglutide was examined in the SURPASS-2 trial that was included in this systematic review. For AEs, there was increase odds of experiencing gastrointestinal AEs with tirzepatide compared to placebo, but no significant difference with semaglutide. CONCLUSION: Tirzepatide has significant potential as a weight loss drug in patients with overweight and obesity, with little increase in AEs compared to other weight loss drugs. With its ability to concurrently target multiple aspects of metabolic syndrome, it should be considered as the next helm of weight loss therapies. CI - (c) 2023. The Author(s), under exclusive licence to Springer Nature Limited. FAU - Tan, Bryan AU - Tan B AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. FAU - Pan, Xin-Hui AU - Pan XH AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. FAU - Chew, Han Shi Jocelyn AU - Chew HSJ AD - Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. FAU - Goh, Rachel Sze Jen AU - Goh RSJ AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. FAU - Lin, Chaoxing AU - Lin C AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. FAU - Anand, Vickram Vijay AU - Anand VV AD - Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. FAU - Lee, Ethan Cheng Zhe AU - Lee ECZ AD - Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. FAU - Chan, Kai En AU - Chan KE AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. FAU - Kong, Gwyneth AU - Kong G AD - Ministry of Health Holdings, Ministry of Health, Singapore, Singapore. FAU - Ong, Christen En Ya AU - Ong CEY AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. FAU - Chung, Hui Charlotte AU - Chung HC AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. FAU - Young, Dan Yock AU - Young DY AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. FAU - Chan, Mark Y AU - Chan MY AUID- ORCID: 0000-0003-0389-7450 AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. AD - Department of Cardiology, National University Heart Centre, Singapore, Singapore. FAU - Khoo, Chin Meng AU - Khoo CM AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. AD - Department of Endocrinology, National University Hospital, Singapore, Singapore. FAU - Mehta, Anurag AU - Mehta A AD - VCU Health Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA. FAU - Muthiah, Mark Dhinesh AU - Muthiah MD AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. AD - Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore. AD - National University Centre for Organ Transplantation, National University Health System, Singapore, Singapore. FAU - Noureddin, Mazen AU - Noureddin M AD - Cedars-Sinai Fatty Liver Program, Division of Digestive and Liver Diseases, Department of Medicine, Comprehensive Transplant Centre, Cedars-Sinai Medical Centre, Los Angeles, CA, USA. FAU - Ng, Cheng Han AU - Ng CH AD - Ministry of Health Holdings, Ministry of Health, Singapore, Singapore. chenhanng@gmail.com. FAU - Chew, Nicholas W S AU - Chew NWS AUID- ORCID: 0000-0002-0640-0430 AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. AD - Department of Cardiology, National University Heart Centre, Singapore, Singapore. FAU - Chin, Yip Han AU - Chin YH AUID- ORCID: 0000-0002-8417-5996 AD - Ministry of Health Holdings, Ministry of Health, Singapore, Singapore. yiphan97@gmail.com. LA - eng PT - Journal Article PT - Meta-Analysis PT - Review PT - Systematic Review DEP - 20230531 PL - England TA - Int J Obes (Lond) JT - International journal of obesity (2005) JID - 101256108 RN - OYN3CCI6QE (tirzepatide) RN - 59392-49-3 (Gastric Inhibitory Polypeptide) RN - 0 (Anti-Obesity Agents) RN - 0 (Hypoglycemic Agents) RN - 0 (Glucagon-Like Peptide-1 Receptor) SB - IM MH - Humans MH - Overweight/drug therapy MH - Obesity/drug therapy MH - Gastric Inhibitory Polypeptide MH - *Anti-Obesity Agents/adverse effects MH - Weight Loss MH - *Diabetes Mellitus, Type 2 MH - Hypoglycemic Agents MH - Glucagon-Like Peptide-1 Receptor EDAT- 2023/05/31 01:09 MHDA- 2023/07/24 06:42 CRDT- 2023/05/30 23:20 PHST- 2022/12/30 00:00 [received] PHST- 2023/04/26 00:00 [accepted] PHST- 2023/04/23 00:00 [revised] PHST- 2023/07/24 06:42 [medline] PHST- 2023/05/31 01:09 [pubmed] PHST- 2023/05/30 23:20 [entrez] AID - 10.1038/s41366-023-01321-5 [pii] AID - 10.1038/s41366-023-01321-5 [doi] PST - ppublish SO - Int J Obes (Lond). 2023 Aug;47(8):677-685. doi: 10.1038/s41366-023-01321-5. Epub 2023 May 31.