What is the evidence regarding the safety of new obesity pharmacotherapies

• Published in: International Journal of Obesity Vol. 49; no. 3; pp. 402 - 411
• Main Authors: Vidal, Josep, Flores, Lílliam, Jiménez, Amanda, Pané, Adriana, de Hollanda, Ana
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.03.2025
• Subjects: Anti-Obesity Agents - adverse effects; Anti-Obesity Agents - therapeutic use; Clinical trials; Comorbidity; Diabetes mellitus (non-insulin dependent); Drug therapy; Drugs; Effectiveness; Glucagon-Like Peptide 1; Glucagon-Like Peptide-1 Receptor Agonists - adverse effects; Glucagon-Like Peptide-1 Receptor Agonists - therapeutic use; Glucagon-Like Peptides - adverse effects; Glucagon-Like Peptides - therapeutic use; Health services; Humans; Liraglutide - adverse effects; Liraglutide - therapeutic use; Obesity; Obesity - drug therapy; Randomized Controlled Trials as Topic; Receptors; Safety; Tirzepatide - adverse effects; Tirzepatide - therapeutic use
• ISSN: 0307-0565; 1476-5497; 1476-5497
• DOI: 10.1038/s41366-024-01488-5

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.