A eficácia da liraglutida no tratamento da obesidade - uma revisão integrativa
DOI:
https://doi.org/10.34119/bjhrv6n6-057Keywords:
obesidade, diabetes, liraglutida, tratamentoAbstract
A taxa de obesidade em adultos e a prevalência de sobrepeso e obesidade entre crianças são crescentes, sugerindo um aumento de comorbidades relacionadas a obesidade. Nesse sentido, se faz necessária a implantação de medidas eficazes para o combate da obesidade e consequente redução das doenças por ela desencadeadas. E, nesse contexto, surgem as drogas antiobesidade como a Liraglutida que teve sua efetividade demonstrada no tratamento do diabetes, entretanto poucos estudos avaliaram sua eficácia na perda de peso. Desta forma, o objetivo dessa revisão de literatura foi analisar a eficácia da liraglutida no tratamento da obesidade em diferentes contextos de saúde. Para realização do artigo foram utilizadas as bases de dados National Library of Medicine (PubMed) e a Biblioteca Virtual em Saúde -Brasil (BVS-Brasil). A busca foi realizada com as palavras chave “liraglutide”,”obesity” e “treatment effectiveness”,sendo a busca da seguinte forma: “liraglutide” and “ obesity” and “treatment effectiveness” . Como critérios de inclusão foram utilizados texto completo gratuito e do tipo ensaio clinico controlado, publicados entre 2015 e 2022. Já os critérios de exclusão utilizados foram fuga ao tema, artigos que não eram do tipo ensaio clínico e artigos duplicados. Após a aplicação dos critérios de inclusão e exclusão, seguida da leitura dos trabalhos, foram selecionados 18 artigos do PubMed e 4 artigos do BVS-Brasil, resultando em um total de 22 artigos. Os resultados desse estudo mostraram que em todos os 22 estudos analisados, a liraglutida se mostrou como um medicamento eficaz nos indivíduos obesos assim como nos obesos portadores de Diabetes, com diminuição significativa do peso. Em conclusão, sugere-se que o uso desse fármaco como medida para controle da obesidade e sobrepeso é eficaz nos diferentes contextos de saúde analisados.
References
Gadde KM, Martin CK, Berthoud HR, Heymsfield SB. Obesity: Pathophysiology and Management. J Am Coll Cardiol. 2018 Jan 2;71(1):69-84.
Inoue Y, Qin B, Poti J, Sokol R, Gordon-Larsen P. Epidemiology of Obesity in Adults: Latest Trends. Curr Obes Rep. 2018 Dec;7(4):276-88
Gadde KM, Atkins KD. The limits and challenges of antiobesity pharmacotherapy. Expert Opin Pharmacother. 2020 Aug;21(11):1319-28
Alruwaili H, Dehestani B, le Roux CW. Clinical Impact of Liraglutide as a Treatment of Obesity. Clin Pharmacol. 2021 Mar 11;13:53-60.
Carlsson Petri KC, Hale PM, Hesse D, Rathor N, Mastrandrea LD. Liraglutide pharmacokinetics and exposure-response in adolescents with obesity. Pediatr Obes. 2021 Oct;16(10):e12799.
Wharton S, Haase CL, Kamran E, Liu A, Mancini J, Neish D, et al. Weight loss and persistence with liraglutide 3.0 mg by obesity class in the real-world effectiveness study in Canada. Obes Sci Pract. 2020 May 9;6(4):439-44.
Hu Y ,Zheng SL ,Ye XL ,Shi JN ,Zheng XW ,Pan HS, et al. Análise de custo efetividade de 4GLP-1RAs no tratamento da obesidade em um cenário dos EUA. Ann transl Med.2022;10(3):152.
Haase C, L, Serratore Achenbach M, G, Lucrezi G, Jeswani N, Maurer S, Egermann U: Use of Liraglutide 3.0 mg for Weight Management in a Real-World Setting in Switzerland. Obes Facts 2021;14:568-76.
Bensignor MO, Bomberg EM, Bramante CT, Divyalasya TVS, Hale PM, Ramesh CK, et al. Effect of liraglutide treatment on body mass index and weight parameters in children and adolescents with type 2 diabetes: Post hoc analysis of the ellipse trial. Pediatr Obes. 2021 Aug;16(8):e12778.
Tronieri JS, Wadden TA, Walsh O, Berkowitz RI, Alamuddin N, Chao AM. Measures of adherence as predictors of early and total weight loss with intensive behavioral therapy for obesity combined with liraglutide 3.0 mg. Behav Res Ther. 2020 Aug;131:e103639.
Webb DR, Htike ZZ, Swarbrick DJ, Brady EM, Gray LJ, Biglands J,et al. A randomized, open-label, active comparator trial assessing the effects of 26 weeks of liraglutide or sitagliptin on cardiovascular function in young obese adults with type 2 diabetes. Diabetes Obes Metab. 2020 Jul;22(7):1187-96.
Garvey WT, Birkenfeld AL, Dicker D, Mingrone G, Pedersen SD, Satylganova A, et al. Efficacy and Safety of Liraglutide 3.0 mg in Individuals With Overweight or Obesity and Type 2 Diabetes Treated With Basal Insulin: The SCALE Insulin Randomized Controlled Trial. Diabetes Care. 2020 May;43(5):1085-93.
Wadden TA, Tronieri JS, Sugimoto D, Lund MT, Auerbach P, Jensen C, Rubino D. Liraglutide 3.0 mg and Intensive Behavioral Therapy (IBT) for Obesity in Primary Care: The SCALE IBT Randomized Controlled Trial. Obesity (Silver Spring). 2020 Mar;28(3):529-36.
Peradze N, Farr OM, Perakakis N, Lázaro I, Sala-Vila A, Mantzoros CS. Short-term treatment with high dose liraglutide improves lipid and lipoprotein profile and changes hormonal mediators of lipid metabolism in obese patients with no overt type 2 diabetes mellitus: a randomized, placebo-controlled, cross-over, double-blind clinical trial. Cardiovasc Diabetol. 2019 Oct 31;18(1):141.
Tronieri JS, Wadden TA, Walsh OA, Berkowitz RI, Alamuddin N, Gruber K,et al. Effects of liraglutide plus phentermine in adults with obesity following 1 year of treatment by liraglutide alone: A randomized placebo-controlled pilot trial. Metabolism. 2019 Jul; 96:83-91
Mastrandrea LD, Witten L, Carlsson Petri KC, Hale PM, Hedman HK, Riesenberg RA. Liraglutide effects in a paediatric (7-11 y) population with obesity: A randomized, double-blind, placebo-controlled, short-term trial to assess safety, tolerability, pharmacokinetics, and pharmacodynamics. Pediatr Obes. 2019 May;14(5):e12495.
Wadden TA, Walsh OA, Berkowitz RI, Chao AM, Alamuddin N, Gruber K, Leonard S, Mugler K, Bakizada Z, Tronieri JS. Terapia Comportamental Intensiva para Obesidade Combinada com Liraglutida 3,0 mg: Um Ensaio Controlado Randomizado. Obesidade (Primavera Prateada). 2019 janeiro;27(1):75-86.
Sharma A, Ambrosy AP, DeVore AD, Margulies KB, McNulty SE, Mentz RJ, et al. Liraglutide and weight loss among patients with advanced heart failure and a reduced ejection fraction: insights from the FIGHT trial. ESC Heart Fail. 2018 Dec;5(6):1035-43.
Kolotkin RL, Gabriel Smolarz B, Meincke HH, Fujioka K. Improvements in health-related quality of life over 3 years with liraglutide 3.0 mg compared with placebo in participants with overweight or obesity. Clin Obes. 2018 Feb;8(1):1-10.
le Roux C, Aroda V, Hemmingsson J, Cancino AP, Christensen R, Pi-Sunyer X. Comparison of Efficacy and Safety of Liraglutide 3.0 mg in Individuals with BMI above and below 35 kg/m²: A Post-hoc Analysis. Obes Facts. 2017;10(6):531-44.
Larsen JR, Vedtofte L, Jakobsen MSL, Jespersen HR, Jakobsen MI, Svensson CK, et al. Effect of Liraglutide Treatment on Prediabetes and Overweight or Obesity in Clozapine- or Olanzapine-Treated Patients With Schizophrenia Spectrum Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2017 Jul 1;74(7):719-28.
Danne T, Biester T, Kapitzke K, Jacobsen SH, Jacobsen LV, Petri KCC,et al. Liraglutide in an Adolescent Population with Obesity: A Randomized, Double-Blind, Placebo-Controlled 5-Week Trial to Assess Safety, Tolerability, and Pharmacokinetics of Liraglutide in Adolescents Aged 12-17 Years. J Pediatr. 2017 Feb;181:146-153.e3
Jensterle M, Kravos NA, Goričar K, Janez A. Short-term effectiveness of low dose liraglutide in combination with metformin versus high dose liraglutide alone in treatment of obese PCOS: randomized trial. BMC Endocr Disord. 2017 Jan 31;17(1):5.
Fujioka K, O'Neil PM, Davies M, Greenway F, Claudius B, Skjøth TV, et al. Early Weight Loss with Liraglutide 3.0 mg Predicts 1-Year Weight Loss and is Associated with Improvements in Clinical Markers. Obesity (Silver Spring). 2016 Nov;24(11):2278-88.
Blackman A, Foster GD, Zammit G, Rosenberg R, Aronne L, Wadden T,et al. Effect of liraglutide 3.0 mg in individuals with obesity and moderate or severe obstructive sleep apnea: the SCALE Sleep Apnea randomized clinical trial. Int J Obes (Lond). 2016 Aug;40(8):1310-9.
Kuhadiya ND, Dhindsa S, Ghanim H, Mehta A, Makdissi A, Batra M, et al. Addition of Liraglutide to Insulin in Patients With Type 1 Diabetes: A Randomized Placebo-Controlled Clinical Trial of 12 Weeks. Diabetes Care. 2016 Jun;39(6):1027-35.
de Boer SA, Lefrandt JD, Petersen JF, Boersma HH, Mulder DJ, Hoogenberg K. The effects of GLP-1 analogues in obese, insulin-using type 2 diabetes in relation to eating behaviour. Int J Clin Pharm. 2016 Feb;38(1):144-51.
Jensterle M, Kravos NA, Pfeifer M, Kocjan T, Janez A. A 12-week treatment with the long-acting glucagon-like peptide 1 receptor agonist liraglutide leads to significant weight loss in a subset of obese women with newly diagnosed polycystic ovary syndrome. Hormones (Athens). 2015 Jan-Mar;14(1):81-90.
Iepsen EW, Lundgren J, Dirksen C, Jensen JE, Pedersen O, Hansen T, et al. Treatment with a GLP-1 receptor agonist diminishes the decrease in free plasma leptin during maintenance of weight loss. Int J Obes (Lond). 2015 May;39(5):834-41.
Kadouh H, Chedid V, Halawi H, Burton DD, Clark MM, Khemani D, Vella A, Acosta A, Camilleri M. O análogo de GLP-1 modula o apetite, a preferência de sabor, os hormônios intestinais e os estoques regionais de gordura corporal em adultos com obesidade. J Clin Endocrinol Metab. 1º de maio de 2020;105(5):1552–63.
Li CJ, Li J, Zhang QM, Lv L, Chen R, Lv CF, Yu P, Yu DM. Comparação de eficácia e segurança entre liraglutida como terapia complementar à insulina e aumento da dose de insulina em indivíduos chineses com diabetes tipo 2 mal controlado e obesidade abdominal. Cardiovasc Diabetol. 15 de novembro de 2012;11:142.
Kim SH, Abbasi F, Lamendola C, Liu A, Ariel D, Schaaf P, Grove K, Tomasso V, Ochoa H, Liu YV, Chen YD, Reaven G. Benefícios do tratamento com liraglutida em idosos com sobrepeso e obesidade com pré-diabetes. Cuidados Diabéticos. 2013 Out;36(10):3276-82.
Kelly AS, Auerbach P, Barrientos-Perez M, Gies I, Hale PM, Marcus C, Mastrandrea LD, Prabhu N, Arslanian S; NN8022-4180 Trial Investigators. A Randomized, Controlled Trial of Liraglutide for Adolescents with Obesity. N Engl J Med. 2020 May 28;382(22):2117-2128.
