A A systematic review and meta-analysis of gastrointestinal adverse events in adults during treatment of obesity with Wegovy
DOI:
https://doi.org/10.59171/nutrivisa-2024v11e12293Keywords:
obesidade; semaglutina; drug-related side effects and adverse reactions.Abstract
It was to review and synthesize RCT-generated evidence on the incidence of gastrointestinal adverse events reported in Wegovy therapy in adults for the treatment of overweight and/or obesity compared to those who, under
It was to review and synthesize Randomized Clinical Trials (RCT) generated evidence on the incidence of gastrointestinal adverse events reported in Wegovy therapy in adults for the treatment of overweight and/or obesity compared to those who, under the same clinical conditions, did not use it. The articles were selected through a systematic search in the electronic database of PubMed, using the PRISMA and PICOS guidelines for the elaboration of the guiding question and the construction of the results. The meta-analysis was developed using the random effect model, using the RStudio software, with the presentation of the aggregated results through the forest plot graph. The degree of heterogeneity between studies was verified using Cochran's Q test and I2. Of the 64 papers initially retrieved, 6 met the eligibility criteria and had their data extracted. Subsequently, these articles with complete applicable data composed the meta-analytic synthesis. The combined analysis of the groups (intervention and control) was expressed in Relative Risk (RR), with the number needed to harm (NNH) calculated. The synthesis of the data included 2,168 participants, it was observed that 561 (25.88%) and 297 (13.7%) of the participants reported gastrointestinal adverse events, such as diarrhea, nausea, vomiting, abdominal pain, after the use of semaglutide and placebo, respectively. The RR was 2.01 (95% CI; 1.34 - 2.99; p = 0.01). Given the evidence found, there is an increased risk of gastrointestinal adverse events, and this was statistically significant and potentially relevant in therapy with semaglutide in adults undergoing treatment for overweight and/or obesity.
References
ANGELIDI, A. M.; BELANGER, M. J.; KOKKINOS, A.; KOLIAKI, C. C. MANTZOROS, C. S. New non-invasive approaches to obesity treatment: from pharmacotherapy to gene therapy. Endocr Rev, v.43,n.3,p.507-557,2022. Doi: https://10.1210/endrev/bnab034
BRASIL, Agência Nacional de Vigilância Sanitária - ANVISA. Wegovy (Semaglutida). Disponível em: https://www.gov.br/anvisa/pt-br/assuntos/medicamentos/novos-medicamentos-e-indicacoes/wegovy-Semaglutida . Acesso em: 17 ago. 2023.
CAPEHORN, M.S.; CATARIG, A.M.; FURBERG, J.K.; JANEZ, A.; PRICE, H.C.; TADAYON, S.; VERGÈS, B.; MARRE, M.; Efficacy and safety of once-weekly semaglutide 1.0mg vs once-daily liraglutide 1.2mg as add-on to 1-3 oral antidiabetic drugs in subjects with type 2 diabetes (SUSTAIN 10). Diabetes Metab, v.46,n.2,p.100-109,2020. Doi: https://10.1016/j.diabet.2019.101117
Carga Global de Doenças. 2019. Disponível em: https://vizhub.healthdata.org/gbd-compare/ . Acesso em: 19 ago. 2023.
Centers for Disease Control and Prevention. CDC. Adult Obesity Prevalence Maps 2023. Disponível em: https://www.cdc.gov/obesity/data/prevalence-maps.html . Acesso em: 19 jul. 2023.
CHAO AM, QUIGLEY KM, WADDEN TA. Dietary interventions for obesity: clinical and mechanistic findings. J Clin Invest, v.131,n.1,p.e140065,2021. Doi: https://10.1172/JCI140065
COOPER AJ, GUPTA SR, MOUSTAFA AF, CHAO AM. Sex/gender differences in obesity prevalence, comorbidities, and treatment. Curr Obes Rep, v.10,n.4,p.458-466,2021. Doi: https://10.1007/s13679-021-00453-x
DA CABRAL, J.S.; MATOS, D.F.; BEZERRA, L.P.; RAMOS, R.E.; AQUINO, M.L.P.; ARAÚJO, M.L.P. MELO, R.L.B.; FREIRE, E.S.; PAZ, W.S.; ALMEIDA, D.H. Carga Global de Doenças: Estimativa e tendência temporal da carga da hanseníase no estado de Alagoas, Brasil entre 2001 e 2019. Research, Society and Development, v.11,n.2,p. e44511225528-e44511225528,2022. Doi: http://dx.doi.org/10.33448/rsd-v11i2.25528
DA SILVA, L.R.; FRANCO, J.V.V.; NESTOR, I.C.N.; SANTOS, J.J.; FONSECA, J.B.; BARBOSA, J.M.; LIMA, A.M.; LABRE, T.B.P.; LEÃO, N.M.L.; GONTIJO, E.E.L. A prática de automedicação em adultos e idosos: uma revisão de literatura. Research, Society and Development, v.11,n.13,p.e411111335692-e411111335692,2022. Doi: https://doi.org/10.33448/rsd-v11i13.35692
DAVIES, M.; FÆRCH, L.; JEPPESEN, O.K.; PAKSERESHT, A.; PEDERSEN, S.D.; PERREAULT, L.; ROSENSTOCK, J.; SHIMOMURA, I.; VILJOEN, A.; WADDEN, T.A.; LINGVAY, I. STEP 2 Study Group. Semaglutide 2•4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet, v.397,n.10278,p.971-984, 2021. Doi: https://10.1016/S0140-6736(21)00213-0
Diretrizes brasileiras de obesidade 2016 / ABESO - Associação Brasileira para o Estudo da Obesidade e da Síndrome Metabólica. – 4.ed. - São Paulo, SP. Disponível em: https://abeso.org.br/wp-content/uploads/2019/12/Diretrizes-Download-Diretrizes-Brasileiras-de-Obesidade-2016.pdf . Acesso em: 19 jul. 2023.
DUARTE, L.S.; SHIRASSU, M.M.; DE MORAES, M.A. Doenças crônicas não transmissíveis DCNT: probabilidade incondicional de morte prematura por doenças crônicas não transmissíveis. BEPA. Boletim Epidemiológico Paulista, v.20,p.1-10,2023. Doi: https://doi.org/10.57148/bepa.2022.v.19.37973
ESTIVALETI, J.M.; GUZMAN-HABINGER, J.; LOBOS, J.; AZEREDO, CM.; CLARO, R.; FERRARI, G.; ADAMI, F.; REZENDE, L.F.M. Time trends and projected obesity epidemic in Brazilian adults between 2006 and 2030. Sci Rep, v.12,n.1,p.12699,2022. Doi: https://10.1038/s41598-022-16934-5
FRIEDRICHSEN, M.; BREITSCHAFT, A.; TADAYON, S.; WIZERT, A.; SKOVGAARD, D. The effect of semaglutide 2.4 mg once weekly on energy intake, appetite, control of eating, and gastric emptying in adults with obesity. Diabetes Obes Metab, v.23,n.3,p.754-762,2021. Doi: https://10.1111/dom.14280
GARVEY, W.T.; BATTERHAM, R.L.; BHATTA, M.; BUSCEMI, S.; CHRISTENSEN, L.N.; FRIAS, J.P.; JÓDAR, E.; KANDLER, K.; RIGAS, G.; WADDEN, T.A.; WHARTON, S. STEP 5 Study Group. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nat Med, v.28,n.10,p.2083-2091,2022. Doi: https://10.1038/s41591-022-02026-4
HOFFMAN DJ, POWELL TL, BARRETT ES, HARDY DB. Origins of the development of metabolic diseases. Physiol Rev, v.101,n.3,p.739-795,2021. Doi: https://10.1152/physrev.00002.2020
IBGE. Pesquisa nacional de saúde: 2019: atenção primária à saúde e informações antropométricas : Brasil / IBGE, Coordenação de Trabalho e Rendimento. Rio de Janeiro: IBGE (2020). Disponível em: https://www.ibge.gov.br/estatisticas/sociais/saude/9160-pesquisa-nacional-de-saude.html . Acesso em: 17 set. 2023.
IQBAL, J.; WU, H.X.; HU, N.; ZHOU, Y.H.; LI, L.; XIAO, F.; WANG, T.; JIANG, H.L.; XU, S.N.; HUANG, B.L.; ZHOU, H.D. Effect of glucagon-like peptide 1 receptor agonists on body weight in obese adults without diabetes mellitus - a systematic review and meta-analysis of randomized controlled trials. Obes Rev, v.23,n.6,p.e13435,2022. Doi: https://10.1111/obr.13435
JENSTERLE, M.; FERJAN, S.; LEŽAIČ, L.; SOČAN, A.; GORIČAR, K.; ZALETEL, K.; JANEZ, A. Semaglutide delays 4-hour gastric emptying in women with polycystic ovary syndrome and obesity. Diabetes Obes Metab, v.25,n.4,p.975-984,2023. Doi: https://10.1111/dom.14944
KOENEN M, HILL MA, COHEN P, SOWERS JR. Obesity, adipose tissue and vascular dysfunction. Circo Res, v.128,n.7,p.951-968,2021. Doi: https://10.1161/CIRCRESAHA.121.318093
MACENO, L.K.; GARCIA, M.S. Fatores de risco para o desenvolvimento de doenças cardiovasculares em jovens adultos/Risk factors for the development of cardiovascular diseases in young adults. Brazilian Journal of Health Review, v.5,n.1,p.2820-2842,2022. Doi: https://doi.org/10.34119/bjhrv5n1-251
MCHILL, A.W.; HULL, J.T.; KLERMAN, E.B. Chronic circadian rhythm disruption and sleep restriction influence subjective hunger, appetite, and food preference. Nutrients, v.14,n.9,p.1800,2022. Doi: https://10.3390/nu14091800
NAKAGAWA, S.; CUTHILL, I.; Effect size, confidence interval and statistical significance: a practical guide for biologists. Biol. Rev, v.82,p.591-605,2007. Doi: https://doi.org/10.1111/j.1469-185x.2007.00027.x
OLIVEIRA, M.S.; MONTOVANI, E.H.; SANTANA, M.F.E.; LEON, A.C.M.P.. MARQUES, M.C. Mortalidade por doença respiratória crônica no Brasil: tendência temporal e projeções. Revista de Saúde Pública, v.56,p.52-61,2022. Doi: https://doi.org/10.11606/s1518-8787.2022056003672
PAGE, M.J.; MCKENZIE, J.E.; BOSSUYT, P.M.; BOUTRON, I.; HOFFMANN, T.C.; MULROW, C.D.; SHAMSEER, L.; TETZLAFF, J.M.; AKL, E.A.; BRENNAN, S.E.; CHOU, R.; GLANVILLE, J.; GRIMSHAW, J.M.; HRÓBJARTSSON, A.; LALU, M.M.; LI, T.; LODER, E.W.; MAYO-WILSON, E.; MCDONALD, S.; MCGUINNESS, L.A.; STEWART, L.A.; THOMAS, J.; TRICCO, A.C.; WELCH, V.A.; WHITING, P.; MOHER, D. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. International journal of surgery, v.75,n.2,p.192,2022. Doi: https://10.1016/j.rec.2021.07.010
PEREZ-MONTES, DE O. A.; PELLITERO, S. PUIG-DOMINGO, M. Obesity and GLP-1. Minerva Endocrinol, v.46,n.2,p.168-176,2021. Doi: https://10.23736/S2724-6507.20.03369-6
REID TJ, KORNER J. Medical and surgical treatment of obesity. Med Clin North Am, v.106,n.5,p837-852,2022. Doi: https://10.1016/j.mcna.2022.03.002
RSTUDIO. Versão 2023.06.1+524 para Windows 10 [software]. Disponível em: http://rstudio.org . Acesso em: 20 set. 2023.
RUBINO, D.; ABRAHAMSSON, N.; DAVIES, M.; HESSE, D.; GREENWAY, F.L. JENSEN, C.; LINGVAY, I.; MOSENZON, O.; ROSENSTOCK, J.; RUBIO, M.A.; RUDOFSKY, G.; TADAYON, S.; WADDEN, T.A.; DICKER, D. STEP 4 Investigators. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA, v.325,n.14,p.1414-1425,2021. Doi: https://10.1001/jama.2021.3224
SAFAEI, M.; SUNDARARAJAN, E.A.; DRISS, M.; BOULILA, W.; SHAPI'I, A. A systematic review of the obesity literature: understanding the causes and consequences of obesity and reviewing various machine learning approaches used to predict obesity. Comput Biol Med, v.136,p.104754,2021. Doi: https://10.1016/j.compbiomed.2021.104754
SAMPAIO, R.M.M.; SOARES, A.P.S.; DOS SANTOS, P.M.R. Estresse no trabalho, estado nutricional e comportamento alimentar: estudo com funcionários de um centro universitário. Revista Brasileira de Nutrição Esportiva, v.16,n.99,p.297-305,2022. Disponível em: https://dialnet.unirioja.es/servlet/articulo?codigo=8680534
SBCBM. Sociedade Brasileira de Cirurgia Bariátrica e Metabólica. 2022. Disponível em: https://www.sbcbm.org.br/obesidade-atinge-mais-de-67-milhoes-de-pessoas-no-brasil-em-2022/#:~:text=Dados%20do%20Minist%C3%A9rio%20da%20Sa%C3%BAde,863.086%20pessoas%20no%20ano%20passado . Acesso em: 19 ago. 2023
SHI, Q.; WANG, Y.; HAO, Q.; VANDVIK, P.O.; GUYATT, G.; LI, J.; CHEN, Z.; XU, S.; SHEN, Y.; GE, L.; SUN, F.; LI, L.; YU, J.; NONG, K.; ZOU, X.; ZHU, S.; WANG, C.; ZHANG, S.; QIAO, Z.; JIAN, Z.; LI, Y.; ZHANG, X.; CHEN, K.; QU, F.; WU, Y.; HE, Y.; TIAN, H.; LI, S. Pharmacotherapy for adults with overweight and obesity: a systematic review and network meta-analysis of randomised controlled trials. Lancet, v.399,n.10321.p, 259-269,2022. Doi: https://10.1016/S0140-6736(21)01640-8
SINGH, G.; KRAUTHAMER, M.; BJALME-EVANS, M. Wegovy (semaglutide): a new weight loss drug for chronic weight management. J Investiga Med, v.70,n.1,p.5-13,2022. Doi: https://10.1136/jim-2021-001952
SISVAN. Sistema de Vigilância Alimentar e Nutricional. 2023. Disponível em: https://sisaps.saude.gov.br/sisvan/relatoriopublico/estadonutricional . Acesso em: 19 ago. 2023.
Sociedade Brasileira de Cirurgia Bariátrica e Metabólica. Obesidade atinge mais de 6,7 milhões de pessoas no Brasil em 2022. Disponível em: https://www.sbcbm.org.br/obesidade-atinge-mais-de-67-milhoes-de-pessoas-no-brasil-em-2022/ . Acesso em: 19 jul. 2023.
TAROZO, M.; PESSA, R.P. Impacto das Consequências Psicossociais do Estigma do Peso no Tratamento da Obesidade: uma Revisão Integrativa da Literatura. Psicologia Ciência e Profissão, v.40,p.1-16,2020. Doi: https://doi.org/10.1590/1982-3703003190910
US. Food and Drug Administration (FDA) . Advancing health through nnovation: new drug therapy approvals 2021. Disponível em: https://www.fda.gov/media/155227/download . Acesso em: 19 ago. 2023.
WHARTON, S.; CALANNA, S.; DAVIES, M.; DICKER, D.; GOLDMAN, B.; LINGVAY, I.; MOSENZON, O.; RUBINO, D.M.; THOMSEN, M.; WADDEN, T.A.; PEDERSEN, S. D. Gastrointestinal tolerability of once-weekly semaglutide 2.4 mg in adults with overweight or obesity, and the relationship between gastrointestinal adverse events and weight loss. Diabetes Obes Metab, v.24,n.1,p.94-105,2022. Doi: https://doi.org/10.1111/dom.14551
WILDING, J.P.H.; BATTERHAM, R.L.; CALANNA, S.; DAVIES, M.; VAN GAAL, L.F.; LINGVAY, I.; MCGOWAN, B.M. ROSENSTOCK, J.; TRAN, M.T.D.; WADDEN, T.A.; WHARTON, S.; YOKOTE, K.; ZEUTHEN, N.; KUSHNER, R.F. STEP 1 Study Group. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med, v.384,n.11,p.989-1002,2021. Doi: https://10.1056/NEJMoa2032183
WORLD HEALTH ORGANIZATION. World health statistics 2023. Disponível em: https://apps.who.int/iris/rest/bitstreams/1502907/retrieve . Acesso em: 19 ago. 2023.
World Obesity Federation, World Obesity Atlas 2023. Disponível em: https://data.worldobesity.org/publications/?cat=19 . Acesso em: 11 set . 2023
ZINMAN, B.; BHOSEKAR, V.; BUSCH, R.; HOLST, I.; LUDVIK, B.; THIELKE, D.; THRASHER, J.; WOO, V.; PHILIS-TSIMIKAS, A. Semaglutide once weekly as add-on to SGLT-2 inhibitor therapy in type 2 diabetes (SUSTAIN 9): a randomised, placebo-controlled trial. Lancet Diabetes Endocrinol, v.7,n.5,p.356-367,2019. Doi: https://10.1016/S2213-8587(19)30066-X
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Lailton Oliveira da Silva, Victor da Silva, Anderson Weiny Barbalho Silva, José Juvenal Linhares
This work is licensed under a Creative Commons Attribution 4.0 International License.
