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The best drug supplement for obesity treatment: a systematic review and network meta-analysis

Salari N 1 , Jafari S 2 , Darvishi N 2 , Valipour E 3 , Mohammadi M 4 , Mansouri K 5 Show all authors , Shohaimi S 6

Affiliations 

  • 1 Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
  • 2 Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
  • 3 Zimagene Medical Genetics Laboratory, Avicenna St, Hamedan, Iran
  • 4 Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran. [email protected]
  • 5 Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
  • 6 Department of Biology, Faculty of Science, University Putra Malaysia, Serdang, Selangor, Malaysia
Diabetol Metab Syndr, 2021 Oct 18;13(1):110.
PMID: 34663429 DOI: 10.1186/s13098-021-00733-5

Abstract

BACKGROUND: Obesity is a complex disease with an increasing prevalence worldwide. There are different weight-management options for obesity treatment, including dietary control, exercise, surgery, and medication. Medications are always associated with different responses from different people. More safety and efficacy of drugs with fewer side effects are valuable for any clinical condition. In this systematic review and network meta-analysis, different anti-obesity drugs are compared to identify the most effective drug.

METHODS: All relevant studies were extracted by searching national and international databases of SID, MagIran, ProQuest, PubMed, Science Direct, Scopus, Web of Science (WoS), and Google Scholar without time limit until October 2020. Finally, the meta-analysis was performed with the 11 remaining studies containing 14 different drug supplements. The standardized mean difference (SMD) was calculated at a 95% confidence interval (CI) to evaluate the effects of each treatment group compared with placebo. A random-effect model was used to evaluate the effect of individual studies on the final result. Heterogeneity and incompatibility of the network were assessed by Cochran's Q and Higgins I2, and the Net Heat chart, respectively. Data analysis was performed using R software.

RESULTS: Our results showed that there were significant mean effects in people intervened with Phentermine 15.0 mg + Topiramate 92.0 mg, Phentermine 7.5 mg + Topiramate 46.0 mg, Pramlintide, Naltrexone + Bupropion 32, and Liraglutide, with SMD effects size = - 9.1, - 7.4, - 6.5, - 5.9, - 5.35, respectively.

CONCLUSION: This study was performed to compare the effect of different drugs used for weight loss in obese patients. The most effective drugs for weight loss were phentermine and topiramate, pramlintide, naltrexone, bupropion, and liraglutide compared to placebo treatment, respectively. This study provides new insights into anti-obesity drugs and hopes to shed new light on future research to manage and treat obesity.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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