{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:19:58Z","timestamp":1753888798176,"version":"3.41.2"},"reference-count":52,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Braz. J. Pharm. Sci."],"abstract":"<jats:p>Abstract To synthesize the evidence about pharmacologic treatment of obesity and overweight and to define the options with the best risk-benefit using the stochastic analysis of multicriteria acceptability (SMAA). The analysis addresses a systematic review (PROSPERO CRD42023423308) whose research was realized in PubMed, Scopus, and Web of Science. Randomized controlled trials were included, which verified the effects of sibutramine, orlistat, liraglutide, and semaglutide in patients with IMC \u2265 26 Kg\/ m\u00b2. The risk of bias analysis was performed with RoB 2.0 and the outcomes evaluated were weight loss and serious adverse events. A total of 102 studies with 45.047 participants were included. The network meta-analysis revealed that all the treatments were significantly more effective than the placebo in weight reduction. The use of semaglutide (especially 0.4 mg\/day) was associated with a bigger weight loss in comparison to all the other treatments (p&lt;0.05) and the analysis of SMAA showed a risk-benefit of 95%. Besides that, we suggest re-evaluating of sibutramine 10mg\/day as a therapeutic option for patients without hypertension or cardiovascular diseases, and we demonstrate the modest weight loss promoted by orlistat 120mg, sibutramine 5mg, and liraglutide 1,8mg and advise against its use, once the benefits do not outweigh the risks.<\/jats:p>","DOI":"10.1590\/s2175-97902025e24177","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T22:13:28Z","timestamp":1737411208000},"source":"Crossref","is-referenced-by-count":0,"title":["Medicines for the management of overweight and obesity: A systematic review with network meta-analysis"],"prefix":"10.1590","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6264-888X","authenticated-orcid":false,"given":"Gabriela Masiero","family":"Marcon","sequence":"first","affiliation":[{"name":"State University of Western Paran\u00e1,  Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3010-6547","authenticated-orcid":false,"given":"Jhonatan Mendes","family":"Paiva","sequence":"additional","affiliation":[{"name":"State University of Western Paran\u00e1,  Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6706-4529","authenticated-orcid":false,"given":"Mariana Delariva","family":"Sakiyama","sequence":"additional","affiliation":[{"name":"State University of Western Paran\u00e1,  Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4262-8608","authenticated-orcid":false,"given":"Fernanda Stumpf","family":"Tonin","sequence":"additional","affiliation":[{"name":"Institute Polytechnic of Lisboa,  Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8529-9595","authenticated-orcid":false,"given":"Fernando","family":"Fernandez-Llimos","sequence":"additional","affiliation":[{"name":"University of Porto,  Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0957-6431","authenticated-orcid":false,"given":"Suzane","family":"Virtuoso","sequence":"additional","affiliation":[{"name":"State University of Western Paran\u00e1,  Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3108-7300","authenticated-orcid":false,"given":"Andreia Cristina Conegero","family":"Sanches","sequence":"additional","affiliation":[{"name":"State University of Western Paran\u00e1,  Brazil"}]}],"member":"530","published-online":{"date-parts":[[2025]]},"reference":[{"issue":"9","key":"ref1","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1001\/archinte.164.9.994","article-title":"The Efficacy and safety of sibutramine for weight loss: A Systematic review","volume":"164","author":"Arterburn DE","year":"2004","journal-title":"Arch Intern Med"},{"issue":"10113","key":"ref2","doi-asserted-by":"crossref","first-page":"2627","DOI":"10.1016\/S0140-6736(17)32129-3","article-title":"Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128\u00b79 million children, adolescents, and adults","volume":"390","author":"Bentham J","year":"2017","journal-title":"Lancet"},{"issue":"5","key":"ref3","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1038\/s41574-019-0176-8","article-title":"Obesity: global epidemiology and pathogenesis","volume":"15","author":"Bl\u00fcher M","year":"2019","journal-title":"Nat Rev Endocrinol"},{"first-page":"1","year":"2015","series-title":"Methodological guidelines: GRADE System - Manual for grading the quality of evidence and strength of recommendation for decision making in health","key":"ref4"},{"first-page":"7","year":"2016","series-title":"Brazilian Obesity Guidelines 2016. 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