Glucagon‐like peptide agonists for weight management in antipsychotic‐induced weight gain: A systematic review and meta‐analysis
Introduction Managing body weight in patients with antipsychotic‐induced weight gain (AIWG) is challenging. Besides lifestyle interventions, pharmacological interventions may contribute to weight loss. This systematic review and meta‐analysis evaluated the effect on weight loss and adverse effects o...
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| Veröffentlicht in: | Acta psychiatrica Scandinavica 2024-12, Vol.150 (6), p.516-529 |
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| creator | Bak, Maarten Campforts, Bea Domen, Patrick Amelsvoort, Therese Drukker, Marjan |
| description | Introduction
Managing body weight in patients with antipsychotic‐induced weight gain (AIWG) is challenging. Besides lifestyle interventions, pharmacological interventions may contribute to weight loss. This systematic review and meta‐analysis evaluated the effect on weight loss and adverse effects of glucagon‐like peptide‐1 (GLP‐1) agonists in patients with AIWG.
Materials and Methods
Following PRISMA guidelines, we performed a meta‐analysis of blinded and open‐label randomised controlled trials (RCTs), non‐randomised controlled trials and cohort studies that evaluated treatment with GLP‐1 in patients with AIWG, regardless of psychiatric diagnosis. PubMed, Embase, PsycINFO and Cochrane Library databases were searched. Primary outcome measures were changes in body weight and BMI. Secondary outcomes were changes in adverse effects and severity of psychopathology due to GLP‐1 agonists.
Results
Only data for exenatide and liraglutide could be included, that is, five RCTs and one cohort study. For exenatide the mean weight loss was −2.48 kg (95% Confidence Interval (CI) −5.12 to +0.64; p = 0.07), for liraglutide the mean weight loss was −4.70 kg (95% CI −4.85 to −4.56; p |
| doi_str_mv | 10.1111/acps.13734 |
| format | Article |
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Managing body weight in patients with antipsychotic‐induced weight gain (AIWG) is challenging. Besides lifestyle interventions, pharmacological interventions may contribute to weight loss. This systematic review and meta‐analysis evaluated the effect on weight loss and adverse effects of glucagon‐like peptide‐1 (GLP‐1) agonists in patients with AIWG.
Materials and Methods
Following PRISMA guidelines, we performed a meta‐analysis of blinded and open‐label randomised controlled trials (RCTs), non‐randomised controlled trials and cohort studies that evaluated treatment with GLP‐1 in patients with AIWG, regardless of psychiatric diagnosis. PubMed, Embase, PsycINFO and Cochrane Library databases were searched. Primary outcome measures were changes in body weight and BMI. Secondary outcomes were changes in adverse effects and severity of psychopathology due to GLP‐1 agonists.
Results
Only data for exenatide and liraglutide could be included, that is, five RCTs and one cohort study. For exenatide the mean weight loss was −2.48 kg (95% Confidence Interval (CI) −5.12 to +0.64; p = 0.07), for liraglutide the mean weight loss was −4.70 kg (95% CI −4.85 to −4.56; p < 0.001). The mean change in BMI was −0.82 (95% CI −1.56 to −0.09; p = 0.03) in the exenatide groups and −1.52 (95% CI −1.83 to −1.22; p < 0.001) in the liraglutide groups. Exenatide and liraglutide did not adversely affect psychopathology. The most common adverse events were nausea, vomiting, and diarrhoea.
Conclusion
The GLP‐1 agonists exenatide and liraglutide are promising drugs for inducing weight loss in patients with AIWG. The adverse effects are acceptable, and the addition of GLP‐1 does not increase the severity of psychopathology. However, more research is needed.</description><identifier>ISSN: 0001-690X</identifier><identifier>ISSN: 1600-0447</identifier><identifier>EISSN: 1600-0447</identifier><identifier>DOI: 10.1111/acps.13734</identifier><identifier>PMID: 39048532</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Agonists ; Antipsychotics ; anti‐obesity medication ; Body weight ; Clinical trials ; Diarrhea ; GLP-1 receptor agonists ; GLP‐1 agonist ; Glucagon ; Meta-analysis ; obesity ; Peptides ; Psychopathology ; Psychotropic drugs ; Side effects ; Systematic review ; Weight control</subject><ispartof>Acta psychiatrica Scandinavica, 2024-12, Vol.150 (6), p.516-529</ispartof><rights>2024 The Author(s). published by John Wiley & Sons Ltd.</rights><rights>2024 The Author(s). Acta Psychiatrica Scandinavica published by John Wiley & Sons Ltd.</rights><rights>2024. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2824-3361588f0f2d1a43bb75b520f594ae7cef28625552e86b6475fd2aecb3e940063</cites><orcidid>0000-0002-6346-2662</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Facps.13734$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Facps.13734$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39048532$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bak, Maarten</creatorcontrib><creatorcontrib>Campforts, Bea</creatorcontrib><creatorcontrib>Domen, Patrick</creatorcontrib><creatorcontrib>Amelsvoort, Therese</creatorcontrib><creatorcontrib>Drukker, Marjan</creatorcontrib><title>Glucagon‐like peptide agonists for weight management in antipsychotic‐induced weight gain: A systematic review and meta‐analysis</title><title>Acta psychiatrica Scandinavica</title><addtitle>Acta Psychiatr Scand</addtitle><description>Introduction
Managing body weight in patients with antipsychotic‐induced weight gain (AIWG) is challenging. Besides lifestyle interventions, pharmacological interventions may contribute to weight loss. This systematic review and meta‐analysis evaluated the effect on weight loss and adverse effects of glucagon‐like peptide‐1 (GLP‐1) agonists in patients with AIWG.
Materials and Methods
Following PRISMA guidelines, we performed a meta‐analysis of blinded and open‐label randomised controlled trials (RCTs), non‐randomised controlled trials and cohort studies that evaluated treatment with GLP‐1 in patients with AIWG, regardless of psychiatric diagnosis. PubMed, Embase, PsycINFO and Cochrane Library databases were searched. Primary outcome measures were changes in body weight and BMI. Secondary outcomes were changes in adverse effects and severity of psychopathology due to GLP‐1 agonists.
Results
Only data for exenatide and liraglutide could be included, that is, five RCTs and one cohort study. For exenatide the mean weight loss was −2.48 kg (95% Confidence Interval (CI) −5.12 to +0.64; p = 0.07), for liraglutide the mean weight loss was −4.70 kg (95% CI −4.85 to −4.56; p < 0.001). The mean change in BMI was −0.82 (95% CI −1.56 to −0.09; p = 0.03) in the exenatide groups and −1.52 (95% CI −1.83 to −1.22; p < 0.001) in the liraglutide groups. Exenatide and liraglutide did not adversely affect psychopathology. The most common adverse events were nausea, vomiting, and diarrhoea.
Conclusion
The GLP‐1 agonists exenatide and liraglutide are promising drugs for inducing weight loss in patients with AIWG. The adverse effects are acceptable, and the addition of GLP‐1 does not increase the severity of psychopathology. However, more research is needed.</description><subject>Agonists</subject><subject>Antipsychotics</subject><subject>anti‐obesity medication</subject><subject>Body weight</subject><subject>Clinical trials</subject><subject>Diarrhea</subject><subject>GLP-1 receptor agonists</subject><subject>GLP‐1 agonist</subject><subject>Glucagon</subject><subject>Meta-analysis</subject><subject>obesity</subject><subject>Peptides</subject><subject>Psychopathology</subject><subject>Psychotropic drugs</subject><subject>Side effects</subject><subject>Systematic review</subject><subject>Weight control</subject><issn>0001-690X</issn><issn>1600-0447</issn><issn>1600-0447</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp90U2rEzEUBuAgire3uvEHSMDN5cLUk6_J1F0pWoWCggruhkzmTG_qfDnJ3DI7V679jf4SU9u6cGE2IeE5LyEvIc8YLFhcL43t_YIJLeQDMmMpQAJS6odkBgAsSZfw5Ypce7-PR8Uge0yuxBJkpgSfkR-berRm17W_vv-s3VekPfbBlUiPd84HT6tuoAd0u7tAG9OaHTbYBupaatrgej_Zuy44G8ddW44WywveGde-oivqJx-wMdHQAe8dHuJgSRsMJs7EwHryzj8hjypTe3x63ufk85vXn9Zvk-37zbv1aptYnnGZCJEylWUVVLxkRoqi0KpQHCq1lAa1xYpnKVdKcczSIpVaVSU3aAuBSwmQijm5OeX2Q_dtRB_yxnmLdW1a7EafC8ikTrXUOtIX_9B9Nw7xvVExLlT8P5BR3Z6UHTrvB6zyfnCNGaacQX5sJz-2k_9pJ-Ln58ixaLD8Sy91RMBO4OBqnP4Tla_WHz6eQn8DHPGekw</recordid><startdate>202412</startdate><enddate>202412</enddate><creator>Bak, Maarten</creator><creator>Campforts, Bea</creator><creator>Domen, Patrick</creator><creator>Amelsvoort, Therese</creator><creator>Drukker, Marjan</creator><general>Blackwell Publishing Ltd</general><scope>24P</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6346-2662</orcidid></search><sort><creationdate>202412</creationdate><title>Glucagon‐like peptide agonists for weight management in antipsychotic‐induced weight gain: A systematic review and meta‐analysis</title><author>Bak, Maarten ; Campforts, Bea ; Domen, Patrick ; Amelsvoort, Therese ; Drukker, Marjan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2824-3361588f0f2d1a43bb75b520f594ae7cef28625552e86b6475fd2aecb3e940063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Agonists</topic><topic>Antipsychotics</topic><topic>anti‐obesity medication</topic><topic>Body weight</topic><topic>Clinical trials</topic><topic>Diarrhea</topic><topic>GLP-1 receptor agonists</topic><topic>GLP‐1 agonist</topic><topic>Glucagon</topic><topic>Meta-analysis</topic><topic>obesity</topic><topic>Peptides</topic><topic>Psychopathology</topic><topic>Psychotropic drugs</topic><topic>Side effects</topic><topic>Systematic review</topic><topic>Weight control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bak, Maarten</creatorcontrib><creatorcontrib>Campforts, Bea</creatorcontrib><creatorcontrib>Domen, Patrick</creatorcontrib><creatorcontrib>Amelsvoort, Therese</creatorcontrib><creatorcontrib>Drukker, Marjan</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Acta psychiatrica Scandinavica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bak, Maarten</au><au>Campforts, Bea</au><au>Domen, Patrick</au><au>Amelsvoort, Therese</au><au>Drukker, Marjan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Glucagon‐like peptide agonists for weight management in antipsychotic‐induced weight gain: A systematic review and meta‐analysis</atitle><jtitle>Acta psychiatrica Scandinavica</jtitle><addtitle>Acta Psychiatr Scand</addtitle><date>2024-12</date><risdate>2024</risdate><volume>150</volume><issue>6</issue><spage>516</spage><epage>529</epage><pages>516-529</pages><issn>0001-690X</issn><issn>1600-0447</issn><eissn>1600-0447</eissn><abstract>Introduction
Managing body weight in patients with antipsychotic‐induced weight gain (AIWG) is challenging. Besides lifestyle interventions, pharmacological interventions may contribute to weight loss. This systematic review and meta‐analysis evaluated the effect on weight loss and adverse effects of glucagon‐like peptide‐1 (GLP‐1) agonists in patients with AIWG.
Materials and Methods
Following PRISMA guidelines, we performed a meta‐analysis of blinded and open‐label randomised controlled trials (RCTs), non‐randomised controlled trials and cohort studies that evaluated treatment with GLP‐1 in patients with AIWG, regardless of psychiatric diagnosis. PubMed, Embase, PsycINFO and Cochrane Library databases were searched. Primary outcome measures were changes in body weight and BMI. Secondary outcomes were changes in adverse effects and severity of psychopathology due to GLP‐1 agonists.
Results
Only data for exenatide and liraglutide could be included, that is, five RCTs and one cohort study. For exenatide the mean weight loss was −2.48 kg (95% Confidence Interval (CI) −5.12 to +0.64; p = 0.07), for liraglutide the mean weight loss was −4.70 kg (95% CI −4.85 to −4.56; p < 0.001). The mean change in BMI was −0.82 (95% CI −1.56 to −0.09; p = 0.03) in the exenatide groups and −1.52 (95% CI −1.83 to −1.22; p < 0.001) in the liraglutide groups. Exenatide and liraglutide did not adversely affect psychopathology. The most common adverse events were nausea, vomiting, and diarrhoea.
Conclusion
The GLP‐1 agonists exenatide and liraglutide are promising drugs for inducing weight loss in patients with AIWG. The adverse effects are acceptable, and the addition of GLP‐1 does not increase the severity of psychopathology. However, more research is needed.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>39048532</pmid><doi>10.1111/acps.13734</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-6346-2662</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Agonists Antipsychotics anti‐obesity medication Body weight Clinical trials Diarrhea GLP-1 receptor agonists GLP‐1 agonist Glucagon Meta-analysis obesity Peptides Psychopathology Psychotropic drugs Side effects Systematic review Weight control |
| title | Glucagon‐like peptide agonists for weight management in antipsychotic‐induced weight gain: A systematic review and meta‐analysis |
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