Efficacy and Safety of Bimagrumab in Adults With Obesity and Metabolic Dysfunction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Chuhan Shao; Hanmo Lin; Jie Yu; Haiyan Chen; Yaolin Ren; Jing Ren; Yuan Zeng; Yifan Wu; Qian Zhang; Xinhua Xiao

doi:10.1111/dom.71156

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Efficacy and Safety of Bimagrumab in Adults With Obesity and Metabolic Dysfunction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Chuhan Shao·Hanmo Lin·Jie Yu·Haiyan Chen·Yaolin Ren·Jing Ren·Yuan Zeng·Yifan Wu·Qian Zhang·Xinhua Xiao

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Abstract

AIMS: This study aims to systematically evaluate the efficacy of bimagrumab on body composition and glucose parameters in adults with obesity and metabolic dysfunction and its safety profile. METHODS: We searched MEDLINE, PubMed, Embase, and the Cochrane Library on April 20, 2026, for randomized controlled trials (RCTs) assessing bimagrumab treatment in adults with obesity, insulin resistance, or type 2 diabetes mellitus (T2DM). The risk of bias was assessed using the Cochrane Risk of Bias tool (RoB 2), and meta-analyses of efficacy and safety data were conducted using R software. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system was used to assess the strength of evidence. The study was registered with PROSPERO (CRD420261377110). RESULTS: Of the 134 retrieved records, 4 RCTs (enrolling 268 participants) were included. The included population represented a broad spectrum of metabolic dysfunction, from obesity and nondiabetic insulin resistance to established T2DM. Compared with placebo, bimagrumab treatment significantly reduced total weight (mean difference [MD] -4.85 kg, 95% confidence interval [CI] -6.82 to -2.88), fat mass (-4.72 kg [-8.05 to -1.40]), and glycated haemoglobin (HbA1c) (-0.13% [-0.23 to -0.03]) and significantly increased total lean mass (1.66 kg [0.81 to 2.51]). However, bimagrumab led to an increase in low-density lipoprotein (LDL) concentrations of 0.47 mmol/L [0.03 to 0.91] and significantly increased incidences of discontinuation (risk ratio [RR] 5.75 [1.61 to 20.46]), muscle spasms (RR 10.44 [4.23 to 25.75]), and diarrhoea (RR 4.91 [2.38 to 10.11]). CONCLUSION: Bimagrumab effectively reversed adverse effects on body composition in obese individuals, resulting in significant fat reduction, increased skeletal muscle mass, and improved glycemic control, suggesting that bimagrumab is a promising new target for personalized metabolic therapy.

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Humans Obesity Randomized Controlled Trials as Topic Antibodies, Monoclonal, Humanized Diabetes Mellitus, Type 2 Insulin Resistance Adult Body Composition Treatment Outcome Blood Glucose Metabolic Diseases antiobesity drug meta‐analysis obesity therapy randomized trial type 2 diabetes Journal Article Systematic Review Meta-Analysis

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Chuhan Shao, Hanmo Lin, Jie Yu, Haiyan Chen, Yaolin Ren, Jing Ren, Yuan Zeng, Yifan Wu, Qian Zhang, Xinhua Xiao. 2026-07-30. Efficacy and Safety of Bimagrumab in Adults With Obesity and Metabolic Dysfunction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.. https://doi.org/10.1111/dom.71156

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Adult subject Antibodies, Monoclonal, Humanized subject Blood Glucose subject Body Composition subject Diabetes Mellitus, Type 2 subject Humans subject Insulin Resistance subject Journal Article subject Journal Article; Systematic Review; Meta-Analysis resource Meta-Analysis subject Obesity subject Systematic reviews study

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