Effects of glucagon-like peptide-1 receptor agonists on metabolic outcomes in antipsychotic-treated patients with schizophrenia: A systematic review and meta-analysis.
Milene Vitória Sampaio Sobral, Rodrigo Bettanim Menechini, Jordana Belgamasco Cavalcanti Marçal et al.
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In 30 seconds
This systematic review and meta-analysis assessed GLP-1 receptor agonists (GLP-1RAs) versus placebo or standard care in antipsychotic-treated patients with schizophrenia. Eight randomized clinical trials involving 523 participants were included. GLP-1RAs reduced body weight (MD -6.47; 95% CI, -9.61 to -3.32), as well as body mass index, waist circumference, and glycated hemoglobin. No significant effects were found for fasting insulin, lipid parameters, or blood pressure. Gastrointestinal adverse events were more frequent with GLP-1RAs.
Key findings
- Body weight was lower with GLP-1RAs (MD -6.47; 95% CI, -9.61 to -3.32) than with placebo or standard care.
- GLP-1RAs reduced body mass index (MD -2.83; 95% CI, -3.81 to -1.86) and waist circumference (MD -5.35; 95% CI, -6.60 to -4.09).
- Glycated hemoglobin decreased with GLP-1RAs (MD -0.32; 95% CI, -0.39 to -0.26); fasting insulin, lipids, and blood pressure showed no significant effects.
- Gastrointestinal adverse events were more frequent; exploratory analyses suggested weight effects differed across individual GLP-1RAs.
Why it matters
Antipsychotic-treated people with schizophrenia face substantial cardiometabolic morbidity, and this synthesis suggests GLP-1RAs can improve several anthropometric and glycemic measures in this population. The findings may inform consideration of metabolic risk management, while the absence of significant effects on lipids and blood pressure and the increased gastrointestinal adverse events are relevant to weighing potential benefits and harms.
What to keep in mind
The evidence comprised eight trials and 523 participants; the abstract does not report follow-up duration or provide agent-specific pooled estimates.