A systematic review and meta-analysis of the efficacy and safety of pharmacological treatments for obesity in adults.

Here a Medline and Embase search was performed up to 31 January 2025 for randomized controlled trials comparing OMMs versus placebo/active comparators in adults.

在此，我们对Medline和Embase进行了检索，直到2025年1月31日，以寻找比较OMMs与安慰剂/活性对照剂的随机对照试验，研究对象为成人。

Primary endpoint was percentage of total body weight loss (TBWL%) at the end of the study.

主要终点是研究结束时总体重的百分比损失（TBWL%）

Secondary endpoints were TBWL% at 1, 2 and ≥3 years, lipid profile, blood pressure, hemoglobin A1c, fasting plasma glucose, mental health, serious adverse events, quality of life, cardiovascular morbidity and mortality, remission of obesity-related complications and all-cause mortality.

次要终点包括1年、2年及≥3年的TBWL%，血脂谱，血压，血红蛋白A1c，空腹血浆葡萄糖，心理健康，严重不良事件，生活质量，心血管发病率和死亡率，肥胖相关并发症的缓解以及全因死亡率。

Fifty-six clinical trials were identified-orlistat (22), semaglutide (14), liraglutide (11), tirzepatide (6), naltrexone/bupropion (5) and phentermine/topiramate (2)-enrolling 60,307 patients (32,598 OMM and 27,709 placebo).

共识别出56项临床试验，包括奥利司他（22项）、司美格鲁肽（14项）、利拉鲁肽（11项）、替拉鲁肽（6项）、纳曲酮/安非他酮（5项）和芬特明/托吡酯（2项），共招募了60,307名患者（32,598名接受OMM治疗和27,709名接受安慰剂治疗）。

All OMMs showed a significantly greater TBWL% versus placebo (P < 0.0001), more than 10% for semaglutide and tirzepatide.

所有OMM治疗组与安慰剂组相比，体重减轻百分比（TBWL%）显著更高（P < 0.0001），其中司美格鲁肽和替拉鲁肽的TBWL%超过10%。

Both tirzepatide and semaglutide showed normoglycemia restoration, remission of type 2 diabetes and reduction in hospitalization due to heart failure.

Tirzepatide和semaglutide均显示出恢复正常血糖水平，2型糖尿病缓解以及因心力衰竭住院率降低。

Semaglutide was effective in reducing major adverse cardiovascular events and reducing pain in knee osteoarthritis.

Semaglutide在减少主要不良心血管事件和减轻膝骨关节炎疼痛方面有效。

Tirzepatide was effective in remission of obstructive sleep apnea syndrome and metabolic dysfunction-associated steatohepatitis.

Tirzepatide在缓解阻塞性睡眠呼吸暂停综合征和代谢功能障碍相关性脂肪性肝炎方面是有效的。

These results support the need to individualize the selection of OMMs.

这些结果支持需要根据个体情况选择OMMs（骨质疏松治疗药物）的必要性。