利拉鲁肽用于超重和肥胖患者有效性的系统评价

Efficacy of Liraglutide for Obesity or Overweight: A Systematic Review

目的采用Meta分析系统评价利拉鲁肽治疗超重和肥胖患者的有效性。方法采用计算机检索英文数据库(MEDLINE、EMbase、CENTRAL)和中文数据库(万方数据库、中国知网、维普数据库),查找利拉鲁肽治疗超重和肥胖患者的随机对照试验(RCT),检索时限截至2015年3月。由2位研究者根据纳入与排除标准独立筛选文献、提取资料并评价质量后,采用Rev Man5.3.0版软件进行Meta分析。结果最终纳入12个RCT,其中英文文献11篇,中文文献1篇。结果显示在降低患者体质量方面,利拉鲁肽组优于安慰药组、胰岛素组、艾塞那肽组、格列美脲组,且差异均有统计学意义[RR=-0.91,95%CI(-1.01,-0.81),P<0.000 01]、[RR=-2.88,95%CI(-3.37,-2.39),P<0.000 01]、[RR=-1.12,95%CI(-1.32,-0.92),P<0.000 01]、[RR=0.45,95%CI(-0.62,-0.27),P<0.000 01]。利拉鲁肽在降低超重和肥胖患者糖化血红蛋白c、收缩压都有明显的效果。结论利拉鲁肽能有效控制超重和肥胖患者的体质量。其远期疗效有待开展更多高质量、大样本、长期随访的RCT加以验证。

Objective To evaluate the effectiveness and safety of liraglutide for obesity or overweight. Methods Random controlled trials of liraglutide for obesity or overweight were gathered from MEDLINE, EMbase, CENTRAL, CNKI, VIP and WanFang. We screened the retrieved studies according to the inclusion and exclusion criteria, evaluated the quality of included studies, and then performed meta-analyses with The Cochrane Collaboration ＇s Revman 5.3.0 software. Results Twelve randomized controlled trials of liraglutide for obesity or overweight were included, in which 11 trials were written in English and one trial in Chinese. The resuhs of meta-analyses showed that the body weight was significantly reduced in the liraglutide group than in placebo, insulin, exenatide and glimepiride groups [ RR=-0.91,95%CI（- 1.01,-0.81） ,P〈0.000 01; RR = -2.88,95%CI（ -3.37, - 2.39）, P〈 0.00001 ; RR = - 1.12,95% CI （ - 1.32, - 0.92）, P〈 0.000 01 ; RR = 0.45,95% CI （-0.62,-0.27） ,P〈0.000 01 ] .Moreover, liraglutide had significant effect in decreasing HbAlc and systolic blood pressure of patients with obesity or overweight. Conclusion Liraglutide is effective for controlling body weight of patients with obesity or overweight.But its long-term efficacy still needs to be confirmed by performing more RCTs with high quality, large sample and long term follow-up.