A study from the Cleveland Clinic (USA) has identified key factors that may affect long-term weight loss in patients with obesity who were prescribed semaglutide either liraglutide injectables for the treatment of type 2 diabetes or obesity. The study is published in ‘JAMA Network Open‘.
In depth
“In patients with obesity who were prescribed semaglutide or liraglutidewe found that long-term weight loss varied significantly depending on the active agent of the medication, the indication for treatment, the dose and persistence with the medication,” he says. Hamlet Gasoyanlead author of the study and researcher at the Cleveland Clinic Value-Based Care Research Center.
The semaglutide (sold under the brands Wegovy and Ozempic) and the liraglutide (sold under the brand names Saxenda and Victoza) are glucagon-like peptide 1 receptor agonists or GLP-1 RA drugs. These medications help reduce blood sugar levels and promote weight loss.
In this study, researchers identified key factors that were associated with long-term weight loss in patients with obesity. They also indicated the elements that were linked to the probability of achieving weight loss. 10% or more. For this purpose, 3,389 adult patients with obesity were included who began treatment with injectable semaglutide or liraglutide between July 1, 2015 and June 30, 2022. Monitoring ended in July 2023.
At the beginning of the studythe mean baseline body mass index among study participants was 38.5; 82.2% had type 2 diabetes as an indication for treatment. Among patients, 68.5% were white, 20.3% were black, and 7.0% were Hispanic. More than half of the participants were women (54.7%). Most patients received treatment for type 2 diabetes. Overall, 39.6% were prescribed semaglutide for type 2 diabetes, 42.6% liraglutide for type 2 diabetes, 11.1% semaglutide for obesity and 6.7% liraglutide for obesity.
More details
The results show that one year after filling the initial prescription, weight change was associated with the following factors: the active ingredient of the medicine. On average, weight change was -5.1% with semaglutide versus -2.2% with liraglutide. Patients experienced a mean weight change of -3.5% at the low maintenance dose versus -6.6% at the high dose. Furthermore, patients receiving type 2 diabetes medications experienced a mean weight change of -3.2% compared to -5.9% in the obesity treatment group.
On average, patients who were persistent on medication at one year experienced a weight change of -5.5% versus -2.8% among patients who had between 90 and 275 days of medication coverage during the year. first year and -1.8% among those who had less than 90 days of coverage. The researchers discovered that four out of ten patients (40.7%) were still taking their medication one year after you have received the initial prescription. The proportion of patients who continued taking semaglutide was 45.8% compared to 35.6% of patients receiving liraglutide.
Among the patients who they persisted with their medication at 12 months, the average reduction in body weight was -12.9% with semaglutide for obesity, compared to -5.9% with semaglutide for type 2 diabetes. body weight was -5.6% with liraglutide for obesity, compared to -3.1% with liraglutide for type 2 diabetes.
Studies have shown that achieving sustained weight loss of 10% or more provides clinically significant health benefits. With that in mind, the Dr. Gasoyan and their colleagues analyzed the proportion of patients who achieved a weight loss of 10% or more.
To take into account
Overall, 37.4% of patients receiving semaglutide for obesity achieved a reduction in body weight of 10% or more, compared to 16.6% of patients who received semaglutide for type 2 diabetes. In comparison, 14.5% of those receiving liraglutide for obesity achieved a reduction in body weight of 10% or more, compared to 9.3% of those receiving liraglutide for type 2 diabetes.
Among the patients who they persisted with their medication one year after their initial prescriptions, the proportion achieving a weight reduction of 10% or more was 61% with semaglutide for obesity, 23.1% with semaglutide for type 2 diabetes, 28.1% with semaglutide for type 2 diabetes, 6% with liraglutide for obesity and 12.3% with liraglutide for type 2 diabetes.
According to the study’s multivariate analysis that took into account relevant sociodemographic and clinical variables, the following factors were associated with higher odds of achieving a weight loss of 10% or more one year after initial prescriptions: patients receiving semaglutide versus liraglutide; a high maintenance dose of the medication versus a low dose; obesity as an indication for treatment against type 2 diabetes; patients who persisted on medication during the first year or had between 90 and 275 days of medication coverage versus less than 90 days of medication coverage; patients who had a higher baseline BMI; patients who were women versus men.
“Our findings could help inform patients and providers about some of the key factors that are associated with the likelihood of achieving sustained weight loss of a magnitude large enough to provide clinically significant health benefits,” notes Dr. Gasoyan. “Real-world data could help manage expectations regarding weight reduction with GLP-1 AR-based medications and reinforce that persistence is key to achieving significant results.” Future research will continue to explore patient persistence and health outcomes on anti-ARGLP-1 medications.
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