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Clinical Research

What is the evidence regarding the safety of new obesity pharmacotherapies

International Journal of Obesity (2024)Cite this article

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Abstract

The use of gut-hormone receptors agonists as new therapeutic options for obesity and some of its related comorbidities, such as type 2 diabetes, has resulted in an unprecedented efficacy in the medical management of people living with obesity (PLWO). Appraisal of the safety of these drugs is of utmost importance considering the large number of PLWO, and the potentially long exposure to these pharmacotherapies. In this narrative review we summarize the evidence on the safety of liraglutide, semaglutide, and tirzepatide as derived from randomized clinical trials conducted in adults living with obesity. Additionally, the safety of these drugs is put into perspective with that of other drugs currently approved for the treatment of PLWO. Overall, the available data support a favorable efficacy versus safety balance for gut-hormone hormone receptor analogues in the treatment of these subjects. Nonetheless, it should be acknowledged that in the context of a chronic disease that has reached epidemic proportions, data from randomized clinical trials aimed primarily at proving the efficacy of these drugs may have been insufficient to unveil all the safety issues. Thus, continuous surveillance on the adverse effects of liraglutide, semaglutide, and tirzepatide is required as we use these drugs in a broader population than that represented in currently available clinical trials.

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Fig. 1: Adverse events associated with treatment with liraglutide, semaglutide, tirzepatide, orlistat, naltrexone-brupopion, or phentermine-topiramate, in people living with obesity.

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Authors and Affiliations

  1. Obesity Unit. Endocrinology and Nutrition Department. Hospital Clínic, Barcelona, Spain

    Josep Vidal, Lílliam Flores, Amanda Jiménez, Adriana Pané & Ana de Hollanda

  2. CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain

    Josep Vidal & Lílliam Flores

  3. Institut D’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain

    Josep Vidal, Lílliam Flores, Amanda Jiménez & Adriana Pané

  4. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute de Salud Carlos III, Madrid, Spain

    Amanda Jiménez, Adriana Pané & Ana de Hollanda

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  4. Adriana Pané
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  5. Ana de Hollanda
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Contributions

Josep Vidal was responsible for designing the review protocol, writing the protocol and report, conducting the search, screening potentially eligible studies, extracting and analyzing data, and updating the reference lists. Lílliam Flores, Amanda Jiménez, Adriana Pané, and Ana de Hollanda revised the draft manuscript, played an important role in ensuring that all relevant issues were covered, and approved the final version of the manuscript.

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Correspondence to Josep Vidal.

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Vidal, J., Flores, L., Jiménez, A. et al. What is the evidence regarding the safety of new obesity pharmacotherapies. Int J Obes (2024). https://doi.org/10.1038/s41366-024-01488-5

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