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Effects of weight loss medications on mortality and cardiovascular events: A systematic review of randomized controlled trials in adults with overweight and obesity.
- Source :
-
Nutrition, metabolism, and cardiovascular diseases : NMCD [Nutr Metab Cardiovasc Dis] 2021 Aug 26; Vol. 31 (9), pp. 2587-2595. Date of Electronic Publication: 2021 May 28. - Publication Year :
- 2021
-
Abstract
- Aims: Adults affected by obesity are at higher risk of premature mortality. Medications can help to lose weight and to maintain weight loss. Aim of this meta-analysis was to assess whether anti-obesity medications affect all-cause mortality, mortality due to cardiovascular events, cardiovascular risk factors and body weight.<br />Data Synthesis: A Medline search was performed to identify randomized controlled trials (RCTs) of anti-obesity medications in adults with overweight or obesity reporting data on all-cause mortality, cardiovascular mortality or non-fatal cardiovascular events, with a follow-up of at least 6 months. We identified 28 RCTs with 50,106 participants. The median follow-up was 52 weeks. Evidence did not show superiority of anti-obesity medications over placebo in reducing all-cause mortality (risk ratio 1.03, 95%Confidence Interval [CI] 0.87 to 1.21) or cardiovascular mortality (risk ratio 0.92, 95%CI 0.72 to 1.18). All-cause mortality rate was positively associated with weight loss (β = 0.0007; p = 0.045); hence, for each kg of body weight lost there was a 0.07% decrease of all-cause mortality. The pharmacological treatment reduced total-cholesterol (7.15 mg/dl; 95%CI 1.46-12.85), LDL-cholesterol (5.06 mg/dl; 95%CI 1.12-9.00), and triglycerides levels (9.88 mg/dl; 95%CI 5.02-14.75), while it increased HDL-cholesterol (1.37 mg/dl; 95%CI 0.17-2.57). Systolic blood pressure decreased (0.90 mmHg; 95%CI 0.15-1.64).<br />Conclusions: Although we were unable to demonstrate a superiority of anti-obesity medications over placebo on mortality, metaregression showed that even a small weight reduction tends to reduce all-cause mortality in obesity. Our data support public health measures to reduce the obesity burden by including the use of anti-obesity medications.<br />Registration Number (prospero): CRD42020210329.<br /> (Copyright © 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Anti-Obesity Agents adverse effects
Cardiovascular Diseases diagnosis
Cardiovascular Diseases mortality
Cardiovascular Diseases physiopathology
Female
Heart Disease Risk Factors
Humans
Male
Obesity diagnosis
Obesity mortality
Obesity physiopathology
Randomized Controlled Trials as Topic
Risk Assessment
Time Factors
Treatment Outcome
Anti-Obesity Agents therapeutic use
Cardiovascular Diseases prevention & control
Obesity drug therapy
Weight Loss drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1590-3729
- Volume :
- 31
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Nutrition, metabolism, and cardiovascular diseases : NMCD
- Publication Type :
- Academic Journal
- Accession number :
- 34154892
- Full Text :
- https://doi.org/10.1016/j.numecd.2021.05.023