Long-Term Efficacy and Safety of Once-Weekly Semaglutide for Weight Loss in Patients Without Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Abstract
Semaglutide, a glucagon-like peptide-1 receptor agonist, has demonstrated clinically important weight loss effects in patients with type 2 diabetes. However, its effects on sustained weight loss among individuals without diabetes remains unclear. Our objective was to examine the long-term efficacy and safety of semaglutide use for weight loss among individuals with overweight/obesity and without diabetes. MEDLINE, Embase, and the Cochrane Libraries were systematically searched to identify randomized controlled trials (RCTs) that randomized participants with overweight/obesity but without diabetes to once-weekly 2.4 mg subcutaneous semaglutide versus placebo with follow-up of at least 68 weeks. The primary outcome was change in relative body weight from baseline to longest follow-up. Random-effects models with inverse variance weighting were used to estimate weighted mean differences (WMDs) and relative risks (RRs) with 95% confidence intervals (CIs). A total of 4 RCTs (n=3,087) were included. Of the 3 trials which provided BMI by category (n=2,783), 94.0% of participants had a baseline BMI ≥30 kg/m2. Compared to placebo, use of semaglutide was associated with substantial decreases in long-term relative (WMD: -12.1%; 95% CI -13.5, -10.7) and absolute body weight (WMD: -12.3 kg; 95% CI -13.6, -11.0). At longest follow-up, 33.4% of participants randomized to semaglutide achieved ≥20% weight loss compared to 2.2% with placebo (RR: 15.08; 95% CI 9.31, 24.43). The risk of…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 3,087 participants or records.
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