Abstract：
OBJECTIVE: Tirzepatide, a newly developed dual glucose-dependent insulinotropic peptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, has received approval for treating type 2 diabetes (T2D) and is currently being studied for its potential in long-term weight control. We aim to explore the safety and efficacy of once-weekly subcutaneous tirzepatide for weight loss in T2D or obese patients.
METHODS: A comprehensive search was performed on various databases including PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov from inception up to April 29, 2024, to identify randomized controlled trials (RCTs) that assessed the efficacy of once-weekly tirzepatide compared to a placebo in adults with or without T2D. The mean difference (MD) and risk ratio (RR) were calculated for continuous and dichotomous outcomes, respectively. The risk of bias was evaluated using the RoB-2 tool (Cochrane), while the statistical analysis was conducted utilizing RevMan 5.4.1 software.
RESULTS: Seven RCTs comprising 4795 individuals ranging from 12 to 72 weeks were identified. Compared to the placebo group, tirzepatide at doses of 5, 10, and 15 mg demonstrated significant dose-dependent weight loss. The mean difference (MD) in the percentage change in body weight (BW) was -8.07% (95% CI -11.01, -5.13; p < 0.00001), -10.79% (95% CI -13.86, -7.71; p < 0.00001), and -11.83% (95% CI -14.52, -9.14; p < 0.00001), respectively. Additionally, the MD in the absolute change in BW was -7.5 kg (95% CI -10.9, -4.1; p < 0.0001), -11.0 kg (95% CI -16.9, -5.2; p = 0.0002), and -11.5 kg (95% CI -16.2, -6.7; p < 0.00001), for the 5, 10, and 15 mg doses, respectively. All three doses of tirzepatide also significantly reduced body mass index and waist circumference. Furthermore, it led to a greater percentage of patients experiencing weight loss exceeding 5, 10, 15, 20, and 25%. Moreover, tirzepatide showed great success in reducing blood pressure, blood sugar levels, and lipid profiles. In terms of safety, gastrointestinal side effects were the most frequently reported adverse events in all three doses of tirzepatide groups, which were generally mild-to-moderate and transient.
CONCLUSIONS: Tirzepatide treatment could lead to remarkable and sustained weight loss that is well-tolerated and safe, representing a novel and valuable therapeutic strategy for long-term weight management.
METHODS: A comprehensive search was performed on various databases including PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov from inception up to April 29, 2024, to identify randomized controlled trials (RCTs) that assessed the efficacy of once-weekly tirzepatide compared to a placebo in adults with or without T2D. The mean difference (MD) and risk ratio (RR) were calculated for continuous and dichotomous outcomes, respectively. The risk of bias was evaluated using the RoB-2 tool (Cochrane), while the statistical analysis was conducted utilizing RevMan 5.4.1 software.
RESULTS: Seven RCTs comprising 4795 individuals ranging from 12 to 72 weeks were identified. Compared to the placebo group, tirzepatide at doses of 5, 10, and 15 mg demonstrated significant dose-dependent weight loss. The mean difference (MD) in the percentage change in body weight (BW) was -8.07% (95% CI -11.01, -5.13; p < 0.00001), -10.79% (95% CI -13.86, -7.71; p < 0.00001), and -11.83% (95% CI -14.52, -9.14; p < 0.00001), respectively. Additionally, the MD in the absolute change in BW was -7.5 kg (95% CI -10.9, -4.1; p < 0.0001), -11.0 kg (95% CI -16.9, -5.2; p = 0.0002), and -11.5 kg (95% CI -16.2, -6.7; p < 0.00001), for the 5, 10, and 15 mg doses, respectively. All three doses of tirzepatide also significantly reduced body mass index and waist circumference. Furthermore, it led to a greater percentage of patients experiencing weight loss exceeding 5, 10, 15, 20, and 25%. Moreover, tirzepatide showed great success in reducing blood pressure, blood sugar levels, and lipid profiles. In terms of safety, gastrointestinal side effects were the most frequently reported adverse events in all three doses of tirzepatide groups, which were generally mild-to-moderate and transient.
CONCLUSIONS: Tirzepatide treatment could lead to remarkable and sustained weight loss that is well-tolerated and safe, representing a novel and valuable therapeutic strategy for long-term weight management.
摘要：
目标：替沙帕肽，一种新开发的双重葡萄糖依赖性促胰岛素肽（GIP）和胰高血糖素样肽-1（GLP-1）受体激动剂，已经获得了治疗2型糖尿病（T2D）的批准，目前正在研究其在长期控制体重方面的潜力。我们旨在探讨T2D或肥胖患者每周一次皮下给药的安全性和有效性。
方法：对包括PubMed、Embase,科克伦图书馆,WebofScience,和ClinicalTrials.gov从开始到2024年4月29日，以确定随机对照试验（RCT），该试验评估了每周一次的替利西帕肽与安慰剂相比在有或没有T2D的成人中的疗效。计算连续和二分结局的平均差异（MD）和风险比（RR），分别。使用RoB-2工具(Cochrane)评估偏倚风险，采用RevMan5.4.1软件进行统计分析。
结果：确定了7个RCT，包括4795名12至72周的个体。与安慰剂组相比，剂量为5,10和15mg的替西平肽显示出显著的剂量依赖性体重减轻.体重（BW）百分比变化的平均差（MD）为-8.07％（95％CI-11.01，-5.13；p<0.00001），-10.79%（95%CI-13.86，-7.71；p<0.00001），和-11.83%（95%CI-14.52，-9.14；p<0.00001），分别。此外,BW绝对变化的MD为-7.5kg（95％CI-10.9，-4.1；p<0.0001），-11.0千克（95%CI-16.9，-5.2；p=0.0002），和-11.5千克（95%CI-16.2，-6.7；p<0.00001），对于5、10和15毫克的剂量，分别。所有三种剂量的替利西帕肽也显著降低体重指数和腰围。此外，这导致体重下降超过5,10,15,20和25%的患者比例更高.此外，替利平肽在降低血压方面取得了巨大的成功，血糖水平,和脂质分布。在安全方面,胃肠道副作用是所有三种剂量的替利西帕肽组中最常见的不良事件。通常是轻度至中度和短暂的。
结论：Tirzepatide治疗可导致显著和持续的体重减轻，且耐受性良好且安全，代表了一种新颖而有价值的长期体重管理治疗策略。
方法：对包括PubMed、Embase,科克伦图书馆,WebofScience,和ClinicalTrials.gov从开始到2024年4月29日，以确定随机对照试验（RCT），该试验评估了每周一次的替利西帕肽与安慰剂相比在有或没有T2D的成人中的疗效。计算连续和二分结局的平均差异（MD）和风险比（RR），分别。使用RoB-2工具(Cochrane)评估偏倚风险，采用RevMan5.4.1软件进行统计分析。
结果：确定了7个RCT，包括4795名12至72周的个体。与安慰剂组相比，剂量为5,10和15mg的替西平肽显示出显著的剂量依赖性体重减轻.体重（BW）百分比变化的平均差（MD）为-8.07％（95％CI-11.01，-5.13；p<0.00001），-10.79%（95%CI-13.86，-7.71；p<0.00001），和-11.83%（95%CI-14.52，-9.14；p<0.00001），分别。此外,BW绝对变化的MD为-7.5kg（95％CI-10.9，-4.1；p<0.0001），-11.0千克（95%CI-16.9，-5.2；p=0.0002），和-11.5千克（95%CI-16.2，-6.7；p<0.00001），对于5、10和15毫克的剂量，分别。所有三种剂量的替利西帕肽也显著降低体重指数和腰围。此外，这导致体重下降超过5,10,15,20和25%的患者比例更高.此外，替利平肽在降低血压方面取得了巨大的成功，血糖水平,和脂质分布。在安全方面,胃肠道副作用是所有三种剂量的替利西帕肽组中最常见的不良事件。通常是轻度至中度和短暂的。
结论：Tirzepatide治疗可导致显著和持续的体重减轻，且耐受性良好且安全，代表了一种新颖而有价值的长期体重管理治疗策略。
