Efficacy and safety of tirzepatide for treatment of overweight or obesity. A systematic review and meta-analysis

• Published in: International Journal of Obesity 2023-08, Vol.47 (8), p.677-685
• Main Authors: Tan, Bryan, Pan, Xin-Hui, Chew, Han Shi Jocelyn, Goh, Rachel Sze Jen, Lin, Chaoxing, Anand, Vickram Vijay, Lee, Ethan Cheng Zhe, Chan, Kai En, Kong, Gwyneth, Ong, Christen En Ya, Chung, Hui Charlotte, Young, Dan Yock, Chan, Mark Y., Khoo, Chin Meng, Mehta, Anurag, Muthiah, Mark Dhinesh, Noureddin, Mazen, Ng, Cheng Han, Chew, Nicholas W. S., Chin, Yip Han
• Format: Article
• Language: English
• Subjects: 692/700/2817; 692/700/565; Anti-Obesity Agents - adverse effects; Body weight; Body weight loss; Clinical trials; Diabetes Mellitus, Type 2; Effectiveness; Epidemiology; Gastric Inhibitory Polypeptide; GLP-1 receptor agonists; Glucagon; Glucagon-like peptide 1; Glucagon-Like Peptide-1 Receptor; Health Promotion and Disease Prevention; Humans; Hypoglycemic Agents; Internal Medicine; Medicine; Medicine & Public Health; Meta-analysis; Metabolic Diseases; Metabolic disorders; Metabolic syndrome; Obesity; Obesity - drug therapy; Overweight; Overweight - drug therapy; Peptides; Placebos; Public Health; Review Article; Safety; Systematic review; Weight control; Weight Loss
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/s41366-023-01321-5

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.