← Anti-obesity drugs × adverse events & safety

SynthesisThe Cochrane database of systematic reviews2026

Long-term effects of weight-reducing drugs in people with hypertension.

Ulrike Spary-Kainz et al.PubMed ↗Full text ↗Publisher ↗

What the trial testedrandomised · 8,283 people · 2026

Randomised comparison

Raised adverse events & safety

+13%+8% to +20%

Bigger than 4 in 10 for adverse events & safety

As reported

RR 1.13, 95% CI 1.08–1.20

Randomised comparison

Raised adverse events & safety

+69%+58% to +80%

Bigger than 7 in 10 for adverse events & safety

As reported

RR 1.69, 95% CI 1.58–1.80

Range includes no effect

No clear effect on adverse events & safety

+13%−16% to +54%

Bigger than 4 in 10 for adverse events & safety

As reported

RR 1.13, 95% CI 0.84–1.54

Range includes no effect

No clear effect on cardiovascular events

2.4×0.8× to 6.7×

Bigger than 9 in 10 for cardiovascular events

As reported

RR 2.39, 95% CI 0.82–6.69

+5 more in the walkthrough ↓

Nine numbers in the abstract

the abstract, start to end

… but the evidence is very uncertain (RR 1.13, 95% CI 0.84 to 1.54; 2 trials, …

… events: high-dose versus placebo: RR 2.39, 95% CI 0.82 to 6.69; 1 trial, 1044 participants; low-dose versus placebo: RR 1.51, 95% CI 0.43 to 5.27; 1 trial, …

… but the evidence is very uncertain (RR 0.85, 95% CI 0.49 to 1.48; 1 trial, …

… all AEs compared to placebo (RR 1.13, 95% CI 1.08 to 1.20; 1 trial, …

… to no effect on all-cause mortality (RR 0.99, 95% CI 0.70 to 1.40; 1 trial, 8283 participants; very low-certainty evidence) and cardiovascular morbidity (RR 1.11, 95% CI 0.87 to 1.41; 1 trial, …

… and placebo in SAEs (RR 1.05, 95% CI 0.96 to 1.14; 1 trial, 8283 participants; moderate-certainty evidence), but naltrexone/bupropion probably increases all AEs compared to placebo (RR 1.69, 95% CI 1.58 to 1.80; 1 trial, …

← favours treatmentfavours comparator →
could be chance
Adverse events & safety
RR 1.130.84–1.54
Cardiovascular events
RR 2.390.82–6.69
Cardiovascular events
RR 1.510.43–5.27
Adverse events & safety
RR 0.850.49–1.48
Adverse events & safety
RR 1.131.08–1.20
All-cause mortality
RR 0.990.70–1.40
All-cause mortality
RR 1.110.87–1.41
Adverse events & safety
RR 1.050.96–1.14
Adverse events & safety
RR 1.691.58–1.80
Anti-obesity drugsCardiovascular eventsAll-cause mortalityAdverse events & safety
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Full record →Abstract, authors, funding and every citing paper · PMID 42318855