<scp>Glucagon‐like peptide</scp> ‐1 receptor agonists in adolescents with overweight or obesity with or without type 2 diabetes multimorbidity—a systematic review and network meta‐analysis
Muhammad Aaqib Shamim, Amol Patil, Ulfat Amin, Tuli Roy, Krishna Raj Tiwari, Noor Husain, Jogender Kumar, Santenna Chenchula, Priyanka Rao, Venkata Ganesh, Shoban Babu Varthya, Surjit Singh, Ravindra Shukla, Ashu Rastogi, Aravind P. Gandhi, Prakasini Satapathy, Ranjit Sah, Bijaya Kumar Padhi, Pradeep Dwivedi, Kamlesh Khunti
Abstract
AIM: To synthesize the evidence on the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in adolescents with overweight or obesity. MATERIALS AND METHODS: For this systematic review and network meta-analysis, we searched five databases and registries until 2 March 2024 for eligible randomized controlled trials (RCTs). The primary outcome was weight change. We did a pairwise meta-analysis to compare GLP-1RAs and placebo, followed by a drug-wise network meta-analysis (NMA) to compare GLP-1RAs against each other. RESULTS: , 95% CI -3.60 to -0.62). The evidence on waist circumference, body fat percentage and adverse events (AEs) was very uncertain. The results remained consistent with subgroup analyses for coexisting type 2 diabetes. Longer therapy duration led to a greater reduction in weight and BMI. In the NMA, semaglutide led to the greatest weight reduction, followed by exenatide, liraglutide and lixisenatide. CONCLUSIONS: The evidence suggests that GLP-1RAs reduce most weight-related outcomes in adolescents, with semaglutide being the most efficacious. There is uncertain evidence on body fat and serious AEs, probably due to fewer studies and low incidence, respectively. Larger RCTs with head-to-head comparisons, pragmatic design, adiposity-related outcomes, and economic evaluation can further guide the use and choice of GLP-1RAs.