title: Exenatide in obese or overweight patients without diabetes: A systematic review and meta-analyses of randomized controlled trials.
abstract: OBJECTIVE
  Exenatide, a glucagon-like peptide-1 (GLP-1) receptor agonist, is increasingly used in obese or overweight patients with diabetes. However, its safety profile and effects on weight loss in non-diabetic obese or overweight population remain unclear. We aimed to evaluate efficacy and safety of exenatide in obese or overweight participants without diabetes.
  
  
  METHODS
  We searched up to January 2016 in MEDLINE (Ovid SP), EMBASE (Ovid SP), Cochrane Central Register of Controlled Trials (CENTRAL), some Chinese databases and ClinicalTrials.gov for randomized controlled trials (RCTs) investigating exenatide in obese or overweight participants without diabetes. The primary outcomes included body weight and body mass index (BMI). We pooled data to calculate the mean differences (MDs) with their 95% confidence intervals (CIs). We assessed overall evidence quality of BMI reduction and weight loss according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
  
  
  RESULTS
  Six randomized controlled trials involving 362 patients were included in the meta- analysis. The follow-up duration ranged from 12 to 24weeks. Compared with control group, a larger body weight loss (MD: -4.47kg; 95% CI: -6.67 to -2.27; P<0.0001), regardless of dosage and population, was achieved by the obese or overweight patients in exenatide group. Exenatide also elicited a greater reduction in
  -0.86kg/m(2); 95% CI: -1.39 to -0.33; P=0.001) and waist circumferences (MD: -1.78cm; 95% CI: -3.13 to -0.44; P=0.009) compared with the control. No significant benefits were showed in exenatide group in terms of blood pressure and lipid profiles. Gastrointestinal adverse events were mostly common during the treatment of exenatide.
  
  
  CONCLUSIONS
  Exenatide could significantly reduce body weight in obese or overweight participants without diabetes, and might be a safe alternative GLP-1 receptor agonist for weight control in such patients. Larger randomized trials with longer follow-up duration are required to confirm the effectiveness and safety of exenatide.
authors.affiliation: Department of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Na
authors.initials: N
authors.lastname: Su
authors.affiliation: Department of Endocrinology and Metabolism, The Third People's Hospital of Chengdu, Chengdu 610031, China; Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Xu
authors.affiliation: Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.affiliation: Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Joey Sum-Wing
authors.initials: JS
authors.lastname: Kwong
authors.affiliation: West China School of Medicine, Sichuan University, Chengdu, 610041, China.
authors.forename: Heyue
authors.initials: H
authors.lastname: Du
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China; West China School of Medicine, Sichuan University, Chengdu, 610041, China.
authors.forename: Kaiun
authors.initials: K
authors.lastname: Ren
authors.affiliation: Department of Endocrinology and Metabolism, The Third People's Hospital of Chengdu, Chengdu 610031, China.
authors.forename: Qianrui
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Biomedical Polymer and Artificial Organs, College of Polymer Science and Engineering, Sichuan University, Chengdu 610065, China.
authors.forename: Jianshu
authors.initials: J
authors.lastname: Li
authors.affiliation: Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China. Electronic address: lisheyu@gmail.com.
authors.forename: Sheyu
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China. Electronic address: hmtian999@126.com.
authors.forename: Haoming
authors.initials: H
authors.lastname: Tian
mesh_terms: D001835:Body Weight / Q000187:drug effects / Q000502:physiology; D003920:Diabetes Mellitus; D000077270:Exenatide; D000067757:Glucagon-Like Peptide-1 Receptor / Q000502:physiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D009765:Obesity / Q000188:drug therapy / Q000378:metabolism; D050177:Overweight / Q000188:drug therapy* / Q000378:metabolism; D010455:Peptides / Q000494:pharmacology / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D014688:Venoms / Q000494:pharmacology / Q000627:therapeutic use*; D015431:Weight Loss / Q000187:drug effects / Q000502:physiology; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
chemical_list: D000067757:Glucagon-Like Peptide-1 Receptor; D007004:Hypoglycemic Agents; D010455:Peptides; D014688:Venoms; D000077270:Exenatide; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
keywords: Body mass index; Exenatide; Meta-analysis; Obesity; Overweight