Liraglutide for Weight Management in the Real World: Significant Weight Loss Even if the Maximal Daily Dose Is Not Achieved

Introduction: Obesity is a global health challenge, and pharmacologic options are emerging. Once daily subcutaneous administration of 3 mg liraglutide, a glucagon like peptide-1 analogue, has been shown to induce weight loss in clinical trials, but real-world effectiveness data are scarce. Methods:...

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Autores principales:	Liesbet Trenson, Sander Trenson, Falco van Nes, Carolien Moyson, Matthias Lannoo, Ellen Deleus, Ann Meulemans, Christophe Matthys, Ann Mertens, Bart Van der Schueren, Roman Vangoitsenhoven
Formato:	article
Lenguaje:	EN
Publicado:	Karger Publishers 2021
Materias:	weight reduction obesity liraglutide metformin Nutrition. Foods and food supply TX341-641 Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/012fee322dbd4e18b690bd93835e9349
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spelling	oai:doaj.org-article:012fee322dbd4e18b690bd93835e93492021-12-02T12:40:22ZLiraglutide for Weight Management in the Real World: Significant Weight Loss Even if the Maximal Daily Dose Is Not Achieved1662-40251662-403310.1159/000520217https://doaj.org/article/012fee322dbd4e18b690bd93835e93492021-11-01T00:00:00Zhttps://www.karger.com/Article/FullText/520217https://doaj.org/toc/1662-4025https://doaj.org/toc/1662-4033Introduction: Obesity is a global health challenge, and pharmacologic options are emerging. Once daily subcutaneous administration of 3 mg liraglutide, a glucagon like peptide-1 analogue, has been shown to induce weight loss in clinical trials, but real-world effectiveness data are scarce. Methods: It is a single-centre retrospective cohort study of patients who were prescribed liraglutide on top of lifestyle adaptations after multidisciplinary evaluation. In Belgium, liraglutide is only indicated for weight management if the BMI is >30 kg/m2 or ≥27 kg/m2 with comorbidities such as dysglycaemia, dyslipidaemia, hypertension, or obstructive sleep apnoea. No indication is covered by the compulsory health care insurance. Liraglutide was started at 0.6 mg/day and uptitrated weekly until 3 mg/day or the maximum tolerated dose. Treatment status and body weight were evaluated at the 4-month routine visit. Results: Between June 2016 and January 2020, liraglutide was prescribed to 115 patients (77% female), with a median age of 47 (IQR 37.7–54.0) years, a median body weight of 98.4 (IQR 90.0–112.2) kg, a BMI of 34.8 (IQR 32.2–37.4) kg/m2, and an HbA1c level of 5.6%. Five (4%) patients did not actually initiate treatment, 9 (8%) stopped treatment, and 8 (7%) were lost to follow-up. At the 4-month visit, the median body weight had decreased significantly by 9.2% to 90.8 (IQR 82.0–103.5) kg (p < 0.001). Patients using 3.0 mg/day (n = 60) had lost 8.0 (IQR 5.8–10.4) kg. The weight loss was similar (p = 0.9622) in patients that used a lower daily dose because of intolerance: 7.4 (IQR 6.2–9.6) kg for 1.2 mg (n = 3), 7.8 (IQR 4.1–7.8) kg for 1.8 mg (n = 16), and 9.0 (IQR 4.8–10.7) kg for 2.4 mg/day (n = 14). Weight loss was minimal if liraglutide treatment was not started or stopped prematurely (median 3.0 [IQR 0.3–4.8] kg, p < 0.001, vs. on treatment). Further analysis showed an additional weight reduction of 1.8 kg in the patients that had started metformin <3 months before the start of liraglutide (p < 0.001). The main reasons for liraglutide discontinuation were gastrointestinal complaints (n = 5/9) and drug cost (n = 2/9). Conclusion: In this selected group of patients, the majority complied with liraglutide treatment over the initial 4-month period and achieved a significant weight loss, irrespective of the maximally tolerated maintenance dose. Addition of metformin induced a small but significant additional weight loss.Liesbet TrensonSander TrensonFalco van NesCarolien MoysonMatthias LannooEllen DeleusAnn MeulemansChristophe MatthysAnn MertensBart Van der SchuerenRoman VangoitsenhovenKarger Publishersarticleweight reductionobesityliraglutidemetforminNutrition. Foods and food supplyTX341-641Nutritional diseases. Deficiency diseasesRC620-627ENObesity Facts, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	weight reduction obesity liraglutide metformin Nutrition. Foods and food supply TX341-641 Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	weight reduction obesity liraglutide metformin Nutrition. Foods and food supply TX341-641 Nutritional diseases. Deficiency diseases RC620-627 Liesbet Trenson Sander Trenson Falco van Nes Carolien Moyson Matthias Lannoo Ellen Deleus Ann Meulemans Christophe Matthys Ann Mertens Bart Van der Schueren Roman Vangoitsenhoven Liraglutide for Weight Management in the Real World: Significant Weight Loss Even if the Maximal Daily Dose Is Not Achieved
description	Introduction: Obesity is a global health challenge, and pharmacologic options are emerging. Once daily subcutaneous administration of 3 mg liraglutide, a glucagon like peptide-1 analogue, has been shown to induce weight loss in clinical trials, but real-world effectiveness data are scarce. Methods: It is a single-centre retrospective cohort study of patients who were prescribed liraglutide on top of lifestyle adaptations after multidisciplinary evaluation. In Belgium, liraglutide is only indicated for weight management if the BMI is >30 kg/m2 or ≥27 kg/m2 with comorbidities such as dysglycaemia, dyslipidaemia, hypertension, or obstructive sleep apnoea. No indication is covered by the compulsory health care insurance. Liraglutide was started at 0.6 mg/day and uptitrated weekly until 3 mg/day or the maximum tolerated dose. Treatment status and body weight were evaluated at the 4-month routine visit. Results: Between June 2016 and January 2020, liraglutide was prescribed to 115 patients (77% female), with a median age of 47 (IQR 37.7–54.0) years, a median body weight of 98.4 (IQR 90.0–112.2) kg, a BMI of 34.8 (IQR 32.2–37.4) kg/m2, and an HbA1c level of 5.6%. Five (4%) patients did not actually initiate treatment, 9 (8%) stopped treatment, and 8 (7%) were lost to follow-up. At the 4-month visit, the median body weight had decreased significantly by 9.2% to 90.8 (IQR 82.0–103.5) kg (p < 0.001). Patients using 3.0 mg/day (n = 60) had lost 8.0 (IQR 5.8–10.4) kg. The weight loss was similar (p = 0.9622) in patients that used a lower daily dose because of intolerance: 7.4 (IQR 6.2–9.6) kg for 1.2 mg (n = 3), 7.8 (IQR 4.1–7.8) kg for 1.8 mg (n = 16), and 9.0 (IQR 4.8–10.7) kg for 2.4 mg/day (n = 14). Weight loss was minimal if liraglutide treatment was not started or stopped prematurely (median 3.0 [IQR 0.3–4.8] kg, p < 0.001, vs. on treatment). Further analysis showed an additional weight reduction of 1.8 kg in the patients that had started metformin <3 months before the start of liraglutide (p < 0.001). The main reasons for liraglutide discontinuation were gastrointestinal complaints (n = 5/9) and drug cost (n = 2/9). Conclusion: In this selected group of patients, the majority complied with liraglutide treatment over the initial 4-month period and achieved a significant weight loss, irrespective of the maximally tolerated maintenance dose. Addition of metformin induced a small but significant additional weight loss.
format	article
author	Liesbet Trenson Sander Trenson Falco van Nes Carolien Moyson Matthias Lannoo Ellen Deleus Ann Meulemans Christophe Matthys Ann Mertens Bart Van der Schueren Roman Vangoitsenhoven
author_facet	Liesbet Trenson Sander Trenson Falco van Nes Carolien Moyson Matthias Lannoo Ellen Deleus Ann Meulemans Christophe Matthys Ann Mertens Bart Van der Schueren Roman Vangoitsenhoven
author_sort	Liesbet Trenson
title	Liraglutide for Weight Management in the Real World: Significant Weight Loss Even if the Maximal Daily Dose Is Not Achieved
title_short	Liraglutide for Weight Management in the Real World: Significant Weight Loss Even if the Maximal Daily Dose Is Not Achieved
title_full	Liraglutide for Weight Management in the Real World: Significant Weight Loss Even if the Maximal Daily Dose Is Not Achieved
title_fullStr	Liraglutide for Weight Management in the Real World: Significant Weight Loss Even if the Maximal Daily Dose Is Not Achieved
title_full_unstemmed	Liraglutide for Weight Management in the Real World: Significant Weight Loss Even if the Maximal Daily Dose Is Not Achieved
title_sort	liraglutide for weight management in the real world: significant weight loss even if the maximal daily dose is not achieved
publisher	Karger Publishers
publishDate	2021
url	https://doaj.org/article/012fee322dbd4e18b690bd93835e9349
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Liraglutide for Weight Management in the Real World: Significant Weight Loss Even if the Maximal Daily Dose Is Not Achieved

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