The examine concentrates on the FDA-approved injectable drugs semaglutide and liraglutide.
A examine carried out by the Cleveland Clinic recognized key components influencing long-term weight loss in sufferers with weight problems who had been prescribed injectable semaglutide or liraglutide for treating sort 2 diabetes or weight problems. The analysis was revealed in JAMA Network Open.
“In patients with obesity who were prescribed semaglutide or liraglutide, we found that long-term weight reduction varied significantly based on the medication’s active agent, treatment indication, dosage, and persistence with the medication,” mentioned Hamlet Gasoyan, Ph.D., lead writer of the examine and a researcher with Cleveland Clinic’s Center for Value-Based Care Research.
Semaglutide (offered below the model names Wegovy and Ozempic) and liraglutide (offered below the model names Saxenda and Victoza) are glucagon-like peptide-1 receptor agonists, or GLP-1 RA drugs. Those FDA-approved drugs assist decrease blood sugar ranges and promote weight loss.
Obesity is a fancy persistent illness that impacts greater than 41% of the U.S. grownup inhabitants. Clinical trials have proven that anti-obesity drugs are efficient; nevertheless, there may be restricted knowledge in real-world settings relating to the components related to long-term weight change and clinically important weight loss.
In this examine, the researchers recognized key components that had been related to long-term weight loss in sufferers with weight problems. They additionally indicated the weather that had been linked to the likelihood of reaching 10% or extra weight loss.
Study Design and Participants
This retrospective cohort examine included 3,389 grownup sufferers with weight problems who initiated remedy with injectable semaglutide or liraglutide between July 1, 2015, and June 30, 2022. Follow-up resulted in July 2023.
At the start of the examine, the median baseline body mass index amongst examine members was 38.5; 82.2% had sort 2 diabetes as a remedy indication. Among the sufferers, 68.5% had been white, 20.3% had been Black, and 7.0% had been Hispanic. More than half of the members had been feminine (54.7%). Most of the sufferers obtained remedy for sort 2 diabetes. Overall, 39.6% had been prescribed semaglutide for sort 2 diabetes, 42.6% liraglutide for sort 2 diabetes, 11.1% semaglutide for weight problems, and 6.7% liraglutide for weight problems.
Key Findings: Weight Loss Factors
Results present that one 12 months after the preliminary prescription’s fill, weight change was related to the next components:
- The treatment’s energetic agent. On common, weight change was -5.1% with semaglutide versus -2.2% with liraglutide.
- The dosage. Patients skilled -3.5% imply weight change with a low upkeep dose versus -6.6% with a high dose.
- Treatment indication. Patients who obtained the drugs for sort 2 diabetes skilled -3.2% in imply weight change in comparison with -5.9% for weight problems remedy.
- Persistence with treatment. On common, sufferers who had been persistent with the treatment at one 12 months skilled -5.5% weight change versus -2.8% amongst sufferers who had 90-275 treatment protection days inside the first 12 months and -1.8% amongst these with lower than 90 lined days.
Researchers discovered that 4 in 10 sufferers (40.7%) had been persistent with their treatment one 12 months after their preliminary prescription’s fill. The proportion of sufferers who had been persistent with semaglutide was 45.8% versus 35.6% in sufferers receiving liraglutide.
Among sufferers who endured with their treatment at 12 months, the common discount in body weight was -12.9% with semaglutide for weight problems, in comparison with -5.9% with semaglutide for sort 2 diabetes. The discount in body weight was -5.6% with liraglutide for weight problems, in comparison with -3.1% with liraglutide for sort 2 diabetes.
Studies have proven that reaching sustained weight loss of 10% or extra supplies clinically important health advantages. With that in thoughts, Dr. Gasoyan and colleagues appeared on the proportion of sufferers who achieved 10% or extra weight discount.
Overall, 37.4% of sufferers receiving semaglutide for weight problems achieved 10% or extra body weight discount in comparison with 16.6% of sufferers receiving semaglutide for sort 2 diabetes. In comparability, 14.5% of these receiving liraglutide for weight problems achieved 10% or extra body weight discount versus 9.3% of these receiving liraglutide for sort 2 diabetes.
Among sufferers who endured with their treatment one 12 months after their preliminary prescriptions, the proportion who achieved 10% or extra weight discount was 61% with semaglutide for weight problems, 23.1% with semaglutide for sort 2 diabetes, 28.6% with liraglutide for weight problems, and 12.3% with liraglutide for sort 2 diabetes.
Achieving Clinically Significant Weight Loss
Based on the examine’s multivariable evaluation that accounted for related socio-demographic and scientific variables, the next components had been related to larger odds of reaching 10% or extra weight discount one 12 months after the preliminary prescriptions:
- Patients who obtained semaglutide versus liraglutide
- A high-maintenance dose of the treatment versus a low
- Obesity as a remedy indication versus sort 2 diabetes
- Patients who endured with the treatment inside the first 12 months or had between 90-275 days of treatment protection versus lower than 90 days of treatment protection
- Patients who had larger preliminary BMI
- Patients who had been feminine versus male
“Our findings could help inform patients and providers regarding some of the key factors that are associated with the probability of achieving sustained weight loss of a magnitude large enough to provide clinically significant health benefits,” mentioned Dr. Gasoyan. “Having real-world data could help manage expectations regarding weight reduction with GLP-1 RA medications and reinforce that persistence is key to achieving meaningful results.”
In a earlier study, Dr. Gasoyan and colleagues appeared on the components influencing the long-term use of anti-obesity drugs. Future analysis will proceed to discover sufferers’ persistence and health outcomes with GLP-1 RA drugs.
Reference: “One-Year Weight Reduction With Semaglutide or Liraglutide in Clinical Practice” by Hamlet Gasoyan, Elizabeth R. Pfoh, Rebecca Schulte, Phuc Le, W. Scott Butsch and Michael B. Rothberg, 13 September 2024, JAMA Network Open.
DOI: 10.1001/jamanetworkopen.2024.33326
Dr. Gasoyan is supported by a grant from the National Cancer Institute.
