EFICÁCIA DOS AGONISTAS DO RECEPTOR DE GLP-1 NO TRATAMENTO DA OBESIDADE SEM DIABETES
REVISÃO INTEGRATIVA
DOI:
https://doi.org/10.63845/27vewf30Keywords:
Agonistas do Receptor de Peptídeo 1 Semelhante ao Glucagon, Obesidade, Perda de PesoAbstract
Objetivo: Avaliar a eficácia dos agonistas do receptor de GLP-1 no tratamento da obesidade em adultos sem diabetes mellitus. Método: Realizou revisão integrativa da literatura com base na estratégia PICO e nas diretrizes PRISMA 2020. Pesquisou ensaios clínicos randomizados na base PubMed, publicados entre 2018 e 2025, envolvendo adultos com IMC ≥30 kg/m² sem diabetes. Incluiu estudos que avaliaram liraglutida, semaglutida, tirzepatida, orforglipron, danuglipron, survodutide e exenatida. Excluiu estudos com comorbidades metabólicas relevantes ou sem desfechos relacionados à perda de peso. Resultados: Incluiu 12 ensaios clínicos. Os agonistas de GLP-1 promoveram reduções significativas e sustentadas do peso corporal, variando aproximadamente entre 5% e 20%, além de melhorias na circunferência abdominal, perfil lipídico, pressão arterial e marcadores inflamatórios. Tirzepatida e doses mais elevadas de semaglutida apresentaram maior magnitude de perda ponderal. Os eventos adversos foram predominantemente gastrointestinais. Conclusão: Demonstra que os agonistas de GLP-1 são eficazes no tratamento da obesidade sem diabetes e oferecem benefícios cardiometabólicos adicionais. Ressalta a necessidade de estudos de longo prazo para avaliar segurança, manutenção da perda de peso e custo-efetividade.
References
Lundgren JR, Janus C, Jensen SBK, Juhl CR, Olsen LM, Christensen RM, et al. Combination of exercise and GLP-1 receptor agonist treatment reduces severity of metabolic syndrome, abdominal obesity, and inflammation: a randomized controlled trial. Lancet Diabetes Endocrinol. 2023 Apr;11(4):289–301.
Ryan DH, Lingvay I, Colhoun HM, Deanfield J, Emerson SS, et al. Long-term weight loss effects of semaglutide in obesity without diabetes in the SELECT trial. N Engl J Med. 2024 Feb;390(5):456–468.
Lincoff AM, Brown-Frandsen K, Colhoun HM, Deanfield J, Emerson SS, Hardt-Lindberg S, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med. 2023 Nov;389(24):2221–2232. DOI: https://doi.org/10.1056/NEJMoa2307563
O’Neil PM, Birkenfeld AL, McGowan B, Mosenzon O, Pedersen SD, Wharton S, et al. Efficacy and safety of semaglutide compared with liraglutide and placebo for weight loss in patients with obesity: a randomised, double-blind, placebo and active controlled, dose-ranging, phase 2 trial. Lancet. 2018 Aug;392(10148):637–649. DOI: https://doi.org/10.1016/S0140-6736(18)31773-2
Wharton S, Astrup A, Endahl L, le Roux CW, Davies M, Lau DCW, et al. Daily oral GLP-1 receptor agonist orforglipron for adults with obesity. N Engl J Med. 2023 Sep;389(10):877–888. DOI: https://doi.org/10.1056/NEJMoa2302392
Aronne LJ, Sattar N, Horn DB, Bays HE, Wharton S, Lin WY, et al. Tirzepatide as compared with semaglutide for the treatment of obesity. N Engl J Med. 2025 Jan;392(3):241–254.
le Roux CW, Astrup A, Fujioka K, Greenway F, Lau DCW, Van Gaal L, et al. Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial. Lancet. 2024 Apr;403(10430):1234–1246. DOI: https://doi.org/10.1016/S2213-8587(23)00356-X
Wharton S, Davies M, Dicker D, Frias JP, Lingvay I, et al. Orforglipron, an oral small-molecule GLP-1 receptor agonist for obesity treatment. N Engl J Med. 2025 Feb;392(6):501–512.
Wharton S, Davies M, Dicker D, Frias JP, Lingvay I, et al. Once-weekly semaglutide 7.2 mg for the treatment of obesity in adults: a phase 3b, double-blind, randomized controlled trial (STEP UP). Lancet. 2025 Jan;405(10310):150–162.
Peradze N, Farr OM, Mantzoros CS, et al. Short-term treatment with high dose liraglutide improves lipid and lipoprotein profile in obese patients without overt type 2 diabetes mellitus: a randomized, placebo-controlled, double-blind clinical trial. Diabetes Obes Metab. 2019 May;21(5):1250–1258. DOI: https://doi.org/10.1186/s12933-019-0945-7
Buckeridge C, Frias JP, Bays HE, Rosenstock J, et al. Efficacy and safety of danuglipron in adults with obesity: a randomized, placebo-controlled, dose-ranging phase 2b study. Lancet Diabetes Endocrinol. 2023 Aug;11(8):605–616.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Arquivos Catarinenses de Medicina
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
