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Aims <p>We meta-analyzed randomized trials to assess efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) after bariatric surgery.</p> Methods <p>We searched PubMed, Embase, and Cochrane Central for randomized trials comparing GLP-1 RAs with placebo after bariatric surgery. Primary outcomes were change in body weight (kg) and HbA1c (%) at 6 and 12 months. We also assessed percent total body weight loss (%TBWL), quality of life, and adverse events. We pooled mean differences (MDs) with 95% confidence intervals (CIs) using random effects and assessed heterogeneity with I² statistic. We also performed an exploratory subgroup analysis that compared very early (≤ 2 months) versus late (≥ 18 months) initiation after surgery.</p> Results <p>Seven RCTs (<i>n</i> = 460) met inclusion criteria; all evaluated liraglutide. GLP-1 RAs increased weight loss at 6 months (MD − 5.33&#xa0;kg; 95% CI − 9.42 to − 1.23; <i>p</i> = 0.02) but not at 12 months (MD − 5.05&#xa0;kg; 95% CI − 22.14 to 12.05; <i>p</i> = 0.33). GLP-1 RAs increased %TBWL at 6 months (MD 5.13%; 95% CI 2.14 to 8.11; <i>p</i> = 0.007) but not at 12 months (MD 3.96%; 95% CI − 3.33 to 11.26; <i>p</i> = 0.18). HbA1c did not differ at 6 or 12 months. Quality of life improved at 6 months in the trials reporting this outcome. Gastrointestinal adverse events were similar between groups. Subgroup analyses suggested differences by initiation timing.</p> Conclusion <p>GLP-1 RA therapy improved short-term weight outcomes after bariatric surgery, with no statistically significant between-group differences at 12 months. Timing of initiation may influence response and should be explored in trials with longer follow up.</p> <p><i>Trial registry</i>: PROSPERO ID CRD420251251321.</p>

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Adjunctive use of glucagon-like peptide-1 receptor agonists after bariatric surgery: updated systematic review and meta-analysis of randomized controlled trials

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月23日

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  • Sakshi Arora,
  • Fnu Amna,
  • Fatemeh Akbarpoor,
  • Dhvanit Rajdeep,
  • Muhammad Khalid,
  • Gabriel Moura Machado,
  • Niman Maalin,
  • Asad Ur Rehman,
  • Marconi Abreu

摘要

Aims

We meta-analyzed randomized trials to assess efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) after bariatric surgery.

Methods

We searched PubMed, Embase, and Cochrane Central for randomized trials comparing GLP-1 RAs with placebo after bariatric surgery. Primary outcomes were change in body weight (kg) and HbA1c (%) at 6 and 12 months. We also assessed percent total body weight loss (%TBWL), quality of life, and adverse events. We pooled mean differences (MDs) with 95% confidence intervals (CIs) using random effects and assessed heterogeneity with I² statistic. We also performed an exploratory subgroup analysis that compared very early (≤ 2 months) versus late (≥ 18 months) initiation after surgery.

Results

Seven RCTs (n = 460) met inclusion criteria; all evaluated liraglutide. GLP-1 RAs increased weight loss at 6 months (MD − 5.33 kg; 95% CI − 9.42 to − 1.23; p = 0.02) but not at 12 months (MD − 5.05 kg; 95% CI − 22.14 to 12.05; p = 0.33). GLP-1 RAs increased %TBWL at 6 months (MD 5.13%; 95% CI 2.14 to 8.11; p = 0.007) but not at 12 months (MD 3.96%; 95% CI − 3.33 to 11.26; p = 0.18). HbA1c did not differ at 6 or 12 months. Quality of life improved at 6 months in the trials reporting this outcome. Gastrointestinal adverse events were similar between groups. Subgroup analyses suggested differences by initiation timing.

Conclusion

GLP-1 RA therapy improved short-term weight outcomes after bariatric surgery, with no statistically significant between-group differences at 12 months. Timing of initiation may influence response and should be explored in trials with longer follow up.

Trial registry: PROSPERO ID CRD420251251321.