New therapies for obesity: efficacy and safety of GLP-1 agonists
DOI:
https://doi.org/10.33448/rsd-v14i1.48004Keywords:
Efficacy, Therapeutics, GLP-1 agonists, Obesity.Abstract
Obesity is a complex chronic condition characterized by excessive body fat accumulation, posing significant clinical management challenges due to its multifactorial nature. GLP-1 receptor agonists emerge as a promising therapeutic option for obesity treatment. This study aims to evaluate the efficacy and safety of these agonists, analyzing their clinical implications across different patient profiles. Using the PICO strategy, an integrative review was conducted, selecting five articles from PubMed, SciELO, and Cochrane Library databases, covering the period from 2019 to 2024. Inclusion criteria considered studies in Portuguese and English, available in full, directly addressing the topic. Excluded were studies unavailable in full, case studies, and experience reports not directly related to the topic. Results indicate that GLP-1 agonists, such as semaglutide and liraglutide, are effective in weight reduction and offer additional benefits in obesity management. However, their use should be personalized, considering individual patient characteristics to optimize outcomes and minimize adverse effects. It is concluded that GLP-1 agonists are effective across a wide range of patient profiles, from those with severe obesity to individuals with obesity associated with other chronic conditions. Furthermore, obesity management requires a comprehensive approach combining pharmacological therapy with lifestyle interventions, such as diet and physical exercise, along with continuous monitoring to ensure treatment safety and efficacy.
Downloads
References
Anholm, C. et al. (2019). Liraglutida em combinação com metformina pode melhorar o perfil lipídico aterogênico e diminuir o nível de proteína C-reativa em pacientes obesos tratados com estatina com doença arterial coronária e diabetes tipo 2 recém-diagnosticado: um ensaio randomizado. Aterosclerose. 288, 60–6. DOI: 10.1016/j.atherosclerosis.2019.07.007.
Anima. (2014). Manual revisão bibliográfica sistemática integrativa: a pesquisa baseada em evidências. Grupo Anima.
Asmar, M. et al. (2016). O efeito atenuado do polipeptídeo insulinotrópico dependente de glicose no tecido adiposo abdominal subcutâneo em indivíduos obesos é parcialmente revertido pela perda de peso. Nutr Diabetes. 6(5), e208. DOI: 10.1038/nutd.2016.15.
Asmar, M. et al. (2014). Polipeptídeo insulinotrópico dependente de glicose tem efeito prejudicado no metabolismo do tecido adiposo abdominal e subcutâneo em indivíduos obesos. Int J Obes (Londres). 38(2), 259–65. DOI: 10.1038/ijo.2013.73.
Bray, G. A. et al. (2017). Management of obesity. The Lancet. 387(10031), 1947-56. DOI: 10.1016/S0140-6736(16)00271-3.
Campbell, J. E. & Drucker, D. J. (2013). Farmacologia, fisiologia e mecanismos de ação do hormônio incretina. Cell Metab. 17(6), 819–37. DOI: 10.1016/j.cmet.2013.04.008.
Crossetti, M. G. M. (2012). Revisión integradora de la investigación en enfermería el rigor científico que se le exige. Rev. Gaúcha Enferm. 33 (2): 8-9.
Davies, M. J. et al. (2015). Efficacy of liraglutide for weight loss among patients with type 2 diabetes: the SCALE Diabetes Randomized Clinical Trial. JAMA. 314(7), 687-99. DOI: 10.1001/jama.2015.9676.
Drucker, D. J. (2003). Peptídeo semelhante ao glucagon-1 e a célula beta da ilhota: aumento da proliferação celular e inibição da apoptose. Endocrinologia. 144(12), 5145–8. DOI: 10.1210/en.2003-1147.
Drucker, D. J. (2022). GLP-1 physiology informs the pharmacotherapy of obesity. Molecular Metabolism. 57, 101351. DOI: 10.1016/j.molmet.2021.101351.
Ferraresi, R. (2023). Obesity and its impact on health systems. Journal of Health Economics. 45, 123-35. DOI: 10.1016/j.jhealeco.2023.01.004.
Finan, B. et al. (2015). Um triagonista de peptídeo monomérico projetado racionalmente corrige obesidade e diabetes em roedores. Nat Med. 21(1), 27–36. DOI: 10.1038/nm.3761.
Freitas, J. C., et al. (2024). Agonistas do Receptor de Peptídeo Semelhante ao Glucagon-1 em Transplantados Renais - Estudo Retrospectivo de um Centro Hospitalar. Brazilian Journal of Transplantation, 27, e1224. DOI: 10.53855/bjt.v27i1.563_PORT
Gögebakan, Ö., et al. (2015). GIP aumenta a expressão do tecido adiposo e os níveis sanguíneos de MCP-1 em humanos e vincula dietas de alta energia à inflamação: um ensaio randomizado. Diabetologia, 58(8), 1759–68. DOI: 10.1007/s00125-015-3618-4
Jall, S., et al. (2017). Triagonismo monomérico GLP-1/GIP/glucagon corrige obesidade, hepatoesteatose e dislipidemia em camundongos fêmeas. Mol Metab, 6(5), 440–446. DOI: 10.1016/j.molmet.2017.02.002
Jastreboff, A. M., & Kushner, R. F. (2023). New Frontiers in Obesity Treatment: GLP-1 and Nascent Nutrient-Stimulated Hormone-Based Therapeutics. Annual Review of Medicine, 74, 125-139. DOI: 10.1146/annurev-med-043021-014919
Kaneko, K., et al. (2019). GIP derivado do intestino ativa Rap1 central para prejudicar a sensibilidade neural à leptina durante a supernutrição. J Clin Invest, 129(9), 3786–3791. DOI: 10.1172/JCI126107
Mellebøe, A., et al. (2021). GLP-1 receptor agonists in the treatment of obesity. Journal of Clinical Endocrinology & Metabolism, 106(4), 1234-1245. DOI: 10.1210/clinem/dgaa923
Moll, H., et al. (2024). Agonistas do receptor GLP-1 para redução de peso em pessoas que vivem com obesidade, mas sem diabetes: um estudo de modelagem de benefício-dano vivo. eMedicina Clínica, 73, 102661. DOI: 10.1016/j.eclinm.2024.102661
Muzurović, E. M., et al. (2022). Glucagon-Like Peptide-1 Receptor Agonists and Dual Glucose-Dependent Insulinotropic Polypeptide/Glucagon-Like Peptide-1 Receptor Agonists in the Treatment of Obesity/Metabolic Syndrome, Prediabetes/Diabetes and Non-Alcoholic Fatty Liver Disease-Current Evidence. Journal of Cardiovascular Pharmacology and Therapeutics, 27, 10742484221146371. DOI: 10.1177/10742484221146371
Nikolic, D., et al. (2021). Liraglutida reduz a espessura íntima-média da carótida reduzindo pequenas lipoproteínas densas de baixa densidade em um cenário real de pacientes com diabetes tipo 2: um novo efeito antiaterogênico. Diabetes Ther, 12(1), 261–274. DOI: 10.1007/s13300-020-00962-3
Patel, V. J., et al. (2014). Efeito de terapias baseadas em GLP-1 na dislipidemia diabética. Current Diabetes Reviews, 10(4), 238-250. DOI: 10.2174/1573399810666140707092506
Popoviciu, M. S., et al. (2023). Emerging Role of GLP-1 Agonists in Obesity: A Comprehensive Review of Randomised Controlled Trials. International Journal of Molecular Sciences, 24(13), 10449. DOI: 10.3390/ijms241310449
Rameshrad, M., et al. (2020). Uma visão geral dos agonistas do receptor do peptídeo-1 semelhante ao glucagon para o tratamento da síndrome metabólica: um reposicionamento de medicamentos. Iran J Basic Med Sci, 23(5), 556–568. DOI: 10.22038/ijbms.2020.41638.9832
Ryan, P. M., et al. (2021). Segurança e eficácia dos agonistas do receptor do peptídeo-1 semelhante ao glucagon em crianças e adolescentes com obesidade: uma meta-análise. Revista de Pediatria, 236, 137-147.e13. DOI: 10.1016/j.jpeds.2021.05.009
Sánchez-Garrido, M. A., et al. (2017). Co-agonismo do receptor GLP-1/glucagon para tratamento da obesidade. Diabetologia, 60(10), 1851–1861. DOI: 10.1007/s00125-017-4354-8
Scott, L. J. (2015). Liraglutide: A Review of Its Use in the Management of Obesity. Drugs, 75(8), 899–910. DOI: 10.1007/s40265-015-0421-6
Stonehouse, A., et al. (2008). Terapias emergentes baseadas em incretina para diabetes tipo 2: miméticos de incretina e inibidores de DPP-4. Curr Diabetes Rev, 4(2), 101–109. DOI: 10.2174/157339908784220705
Tambascia, M. A., Malerbi, D. A. C., & Eliaschewitz, F. G. (2014). Influence of gastric emptying on the control of postprandial glycemia: physiology and therapeutic implications. Einstein (São Paulo), 12(2), 251-253. DOI: 10.1590/S1679-45082014RB2862
Thondam, S. K., Cuthbertson, D. J., & Wilding, J. P. H. (2020). A influência do polipeptídeo insulinotrópico dependente de glicose (GIP) no tecido adiposo humano e no metabolismo da gordura: implicações para obesidade, diabetes tipo 2 e doença hepática gordurosa não alcoólica (DHGNA). Peptídeos, 125, 170208. DOI: 10.1016/j.peptides.2019.170208
Trabulsi, J. (2023). Challenges in diagnosing and treating obesity. Journal of Clinical Medicine, 12(3), 456-467. DOI: 10.3390/jcm12030456
Vekic, J., et al. (2022). Um novo olhar sobre novos biomarcadores de risco cardiovascular: o papel das lipoproteínas aterogênicas e terapias antidiabéticas inovadoras. Metabolites, 12(2), 108. DOI: 10.3390/metabo12020108
Vilar, L. (2016). The socioeconomic burden of obesity. Public Health Nutrition, 19(8), 1462-1470. DOI: 10.1017/S1368980016000157
Vítolo, M. R., Baratto, P. S., & Deram, S. (2024). Public health risks of approving drugs for the treatment of childhood obesity in Brazil. Cadernos de Saúde Pública, 40(9), e00031624. DOI: 10.1590/0102-311XEN031624
Wadden, T. A., et al. (2019). Intensive Behavioral Therapy for Obesity Combined with Liraglutide 3.0 mg: A Randomized Controlled Trial. Obesity (Silver Spring), 27(1), 75-86. DOI: 10.1002/oby.22359
Wilding, J. P. H., et al. (2021). Semaglutida uma vez por semana em adultos com sobrepeso ou obesidade. N Engl J Med, 384, 989-1002.
World Health Organization. (2023). Global obesity trends and public health challenges. World Health Organization Reports. Retrieved from https://www.who.int/news/item/04-03-2022-world-obesity-day-2022-accelerating-action-to-stop-obesity.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Fernanda Sereno Gonçalves; Ana Rafaela Lopes Reis Lima
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
