Eficacia y seguridad de la semaglutida sobre la Fentermina-Topiramato para la pérdida de peso en pacientes con obesidad. Revisión sistemática

Abstract

Title: Efficacy and Safety of Semaglutide versus the Phentermine-Topiramate Combination for Weight Loss in Individuals with Obesity: A Systematic Review. Objectives: To evaluate and compare the efficacy and safety of Semaglutide and the Phentermine-Topiramate combination in weight reduction among adults with obesity. Methodology: Inclusion criteria: Clinical trials and observational studies from the last five years, in English or Spanish, involving individuals over 18 years of age. Reviews, meta-analyses, and grey literature were excluded. Information sources: Searches were conducted in PubMed, Scopus, ScienceDirect, SciELO, and Taylor & Francis between November 2024 and April 2025. Risk of bias: Tools such as RoB 2 were used for clinical trials and JBI for cohort and cross-sectional studies. Data synthesis: A standardized table was used to collect data. Results: Twelve studies were included (8 clinical trials, 3observational studies, and 1 cohort study), encompassing more than 4,000 patients. Semaglutide showed greater efficacy in weight loss (up to 15.8%), while Phentermine- Topiramate achieved between 8–12%. Semaglutide presented more mild to moderate gastrointestinal side effects; Phentermine-Topiramate was associated with more neurological events. Discussion: Semaglutide demonstrated superior efficacy with a manageable safety profile. Conclusions: Semaglutide is more effective than Phentermine-Topiramate for weight loss. Its selection should be based on the patient’s profile and tolerance to adverse effects.