GLP-1 receptor agonists for weight management and potential thromboembolic risk reduction in high risk population with cancer, diabetes, cardiovascular disease: A systematic review.

BACKGROUND: Thromboembolic risk is increased in obesity and cardiometabolic disorders. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) also facilitate weight loss and cardiovascular benefits, yet their effects on thromboembolic events risk reduction in high-risk populations are not completely understood. METHODS: The PRISMA 2020 guidelines were followed to search Scopus, PubMed, Cochrane Library and Web of Science (WoS). We identified 110 records, 8 of which were included in this review. Data extraction, risk of bias assessment and narrative synthesis were independently conducted. RESULTS: GLP-1RAs consistently demonstrated greater weight reduction compared with controls. Semaglutide trials reported up to 15.2 % weight loss versus 2.6 % in controls (p < 0.0001), while liraglutide showed approximately 5 % reduction versus no change. Cardiovascular outcome trials showed significant risk reduction, with hazard ratios of 0.80 (0.72-0.90) and 0.74 (0.58-0.95), indicating decreased major cardiovascular events. However, direct venous thromboembolism reporting was limited; one study showed fewer events (1 vs 3) without statistical significance. Safety profiles were acceptable, with slightly increased gallbladder events (2.8 % vs 2.3 %), rare pancreatitis, and no consistent cancer risk. Serious adverse events were similar or lower in intervention groups (33.4 % vs 36.4 %). CONCLUSION: GLP-1RAs yield substantial weight loss and cardiovascular risk reduction in a high-risk group. There is limited direct evidence about thromboembolism, but there is evidence that it may be beneficial. Their role in reducing thromboembolic risk needs to be confirmed in further large-scale studies.