Chinese herbal medicine is associated with higher body weight reduction than liraglutide among the obese population: A real-world comparative cohort study

Abstract

Introduction: In Taiwan, many people receive Chinese herbal medicine (CHM) as an alternative choice to help control body weight. However, the clinical effectiveness of CHM on weight control has not been well studied, while potential risks and adverse effects are still unknown. The aim of our study is to find out a safe and efficient treatment model of CHM for weight control compared to liraglutide in a real-world setting.Methods: we retrospectively analyzed obese subjects [body mass index (BMI)≧25 kg/m2] from Chang Gung Research Database (2013–2018). We evaluated the effect on body weight and BMI changes in obese groups receiving CHM or western medicine (WM, represented liraglutide) within 180 days. The proportion of subjects who achieved 5 and 10% weight reduction was calculated as well. Furthermore, the potential adverse events were analyzed during the study period. Overlap weighting was used to balance the baseline differences between CHM and WM groups.Results: The full cohort comprised 1,360 participants: 701 in the CHM group and 659 in the WM group. At baseline, the CHM group was younger (42.75 ± 12.12 years old in CHM vs. 52.31 ± 11.7 years old in WM, p-value <0.001) and has more female subjects (77.6% in CHM vs. 53.0% in WM, p-value <0.001). On the other hand, CHM users had lower body weight (79.83 ± 15.66 kg vs. 84.68 ± 17.14 kg, p-value <0.001) and BMI (30.58 ± 5.20 vs. 32.84 ± 6.95, p-value <0.001). At day 180, CHM users lost more body weight (−4.5 ± 4.07 kg vs. −2.15 ± 4.05 kg, p-value <0.001) and higher reduction in BMI (−1.77 ± 1.73 vs. −0.9 ± 2.14, p-value <0.001). A total of 53.21% (n = 373) CHM users lost at least 5% of body weight (22.46% for WM users, p-value <0.001), and 18.97% (n = 132) lost at least 10% of body weight (4.55% for WM users, p-value <0.001). The benefit remained consistent with and without overlap weighting. For adverse events, 18 cases of hypertension occurred in 659 subjects in the WM group (2.7%) in comparison to 1 of 701 subjects in the CHM group (0.1%).Conclusion: CHM led to clinically meaningful weight loss without serious adverse events in a real-world setting. Further clinical trials are warranted to validate this result.

Translational analysis of data science and causal learning in real-world clinical evaluation of traditional Chinese medicine

“…We need to design observational studies further and use causal learning [13,79,80] to control or block confounders, estimate or learn the causal effect of TCM intervention from observational data, and transform the "correlation" evidence in TCM RWD into "causality" evidence. Therefore, using real-world clinical data of TCM and applying causal learning methods to RWCE-TCM [18,38] can obtain higher-level clinical evidence.…”

“…[5–7] To probe into the causal relationship between TCM intervention and clinical outcomes and mine real-world evidence (RWE) from RWD may be an innovative RWCE-TCM approach. [8–18]…”

“…[5][6][7] To probe into the causal relationship between TCM intervention and clinical outcomes and mine real-world evidence (RWE) from RWD may be an innovative RWCE-TCM approach. [8][9][10][11][12][13][14][15][16][17][18] In the digital era, large-scale RWD resources have been established, which include electronic health records from medical information systems, medical insurance systems, disease registration systems, and drug adverse reaction monitoring systems, [17,19] covering all aspects of medical services, medical behaviors, and health management. These records have formed the big data in TCM.…”

Laser Acupuncture versus Liraglutide in Treatment of Obesity: A Multi-Institutional Retrospective Cohort Study

“…The CGRD covers a significant portion of the Taiwanese population, accounting for 12.2% and 21.2% of inpatient and outpatient services, respectively, between 1997 and 2020 [27]. The enormous amount of available medical data renders the CGRD an excellent resource for clinical studies [11,26,28].…”

“…Currently, available therapeutic strategies for weight loss include dieting, lifestyle modifications, exercise, and the use of anti-obesity agents. Research indicates that exercise, diet control, medication, and surgery could result in small-to-modest reductions in body weight [11,12]. Lifestyle modification, including calorie limiting and regular physical activity, is the first-line treatment for alleviating obesity.…”