[PubMed] [Google Scholar] Huang C-S, Chang L-S, et al
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Research focuses on its potential to reduce food intake, promote weight loss, and improve metabolic health, with applications in obesity and diabetes management
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A trial randomly assigned 2254 patients with prediabetes and BMI 30, or BMI 27 with dyslipidemia or hypertension, to receive liraglutide 3 mg daily or placebo in addition to health behaviour changes.31 The time to onset of type 2 diabetes over 160 weeks was 2.7 (95% CI 1.9 to 3.9) times longer with liraglutide 3 mg than with placebo, and the risk of developing diabetes was reduced by 79% with liraglutide (HR 0.21, 95% CI 0.13 to 0.34).31 Orlistat was evaluated in a trial that randomly assigned 3305 patients with BMI 30 and normal (79%) or impaired (21%) glucose tolerance, to receive orlistat 120 mg 3 times daily or placebo, in addition to health behaviour change.32 At 208 weeks, progression to diabetes was observed in 6.2% in the orlistat group versus 9.0% in the placebo group.32 Tirzepatide was evaluated in an RCT that randomly assigned 1032 adults with prediabetes and BMI 30, or BMI 27 with at least 1 obesity-related complication, to receive tirzepatide 5 mg, 10 mg, 15 mg weekly ( n = 762), or placebo ( n = 270), in addition to health behaviour changes.33 At 176 weeks, the risk of progression to type 2 diabetes was decreased by 93% with tirzepatide compared with placebo (HR 0.07, 95% CI 0.0 to 0.1).33 A trial evaluating semaglutide randomly assigned 207 people with BMI 30 and prediabetes to receive semaglutide 2.4 mg ( n = 138) or placebo ( n = 69), in addition to health behaviour changes.34 At 52 weeks, 81% of participants reverted to normoglycemia with semaglutide versus 14% with placebo (odds ratio 19.8, 95% CI 8.7 to 45.2).34 We identified no dedicated RCTs evaluating naltrexonebupropion for the treatment of prediabetes in people with obesity
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