Semaglutide shines as a weight loss therapy

Along with lifestyle management, weekly semaglutide helped obese people lose considerable weight. Semaglutide therapeutic effect (STEP) 1 study in obese people Found.

In a double-blind study of 1,961 adults with a body mass index (BMI) of 30 or higher, adults taking 2.4 mg of semaglutide per week lost an average of 14.9% of baseline body weight after 68 weeks of treatment. However, only 2.4% in the group were placebo and lifestyle interventions only (treatment difference -12.4%, 95% CI -13.4 to -11.5, P<0.001), reported by Dr. Robert Kushner, MD, and colleagues at Northwestern University School of Medicine in Chicago.

A total of 86.4% of adults taking semaglutide were able to lose at least 5% of baseline body weight during the study, compared to 31.5% of adults who adhered to lifestyle interventions alone, the researchers said. I am writing in an online study. New England Journal of Medicine..

Beyond that, nearly 70% of those who received semaglutide and lifestyle interventions achieved weight loss of 10% or more, and more than half were able to lose 15% of baseline weight.

In total, adults receiving semaglutide lost an average of 33.7 pounds (15.3 kg) by week 68, while adults in the placebo / lifestyle intervention group lost only 5.7 pounds (2.6 kg). Not seen (estimated treatment difference-30 lbs) [-12.7 kg], 95% CI -13.7 to -11.7).

Within just four weeks of starting treatment, those taking semaglutide lost more than 2% of their weight and continued to lose weight throughout the 68-week study.

In addition to weight loss, semaglutide contains cardiovascular, including waist circumference, BMI, systolic and diastolic blood pressure, HbA1c, fasting plasma glucose, C-reactive proteins, significant reductions in fasting lipid levels, and physical function scores. Risk factors have also improved. Quality of life.

“I was surprised and happy to see the unprecedented results of the drug,” Kushner said. Today’s MedPage.. “The fact that 50% of participants were able to lose at least 15% of their initial weight and one-third were able to lose at least 20% of their weight is a game changer.”

“Semaglutide is by far the most effective drug intervention we have seen for weight management,” he continued. “We know many of the health concerns of people suffering from weight, such as type 2 diabetes, high blood pressure, and GERD. [gastroesophageal reflux disease], And arthritis of the weight-bearing joints are ameliorated by losing at least 10% of the weight. In this study, nearly 70% of participants were able to achieve this 10% weight loss threshold by taking semaglutide. “

For the next step, Kushner said it was all about doing this. “We need to find ways to encourage and educate healthcare providers to provide obesity treatment in primary care.”

In the STEP 1 trial, 1,961 adults with a BMI of 30 or higher, or adults with a BMI of 27 or higher and at least one weight-related comorbidity, were randomized 2: 1. All participants were baseline non-diabetic (although 40% had pre-diabetes) and about 75% of the cohort were female and white.

Patients receiving semaglutide started with a weekly dose of 0.25 mg for the first 4 weeks and then gradually increased every 4 weeks until a maintenance dose of 2.4 mg was achieved by week 16. ..

Both study groups received individual diet-related counseling sessions every four weeks with the goal of promoting a daily deficiency of 500 kcal, with a goal of 150 minutes of physical activity per week.

The adverse events are similar to those already demonstrated with semaglutide, and gastrointestinal side effects are the most common, the team said.

Overall, about 74% of people taking semaglutide reported at least one gastrointestinal side effect (mainly nausea, diarrhea, vomiting, or constipation), but 48% of people taking placebo. was. Approximately 4.5% of people taking semaglutide discontinued treatment due to a gastrointestinal event, compared to 0.8% of people taking placebo.

In December 2017, the GLP-1 receptor agonist was first approved for injectable doses of 0.5 mg and 1 mg, marketed under the trade name. OzenpickIs indicated for reducing the risk of type 2 diabetes and major cardiovascular events such as heart attack, stroke, and death of adults with type 2 diabetes known for heart disease.And in September 2019, the oral form of semaglutide was approved in 7 and 14 mg tablets and marketed under the trade name. Libersus, Similarly suitable for type 2 diabetes.

Liraglutide, another GLP-1 receptor agonist of Novo Nordisk-sold under the trade name Victorosa 2010 Type 2 Diabetes (1.2 or 1.8 mg / day)-also approved by name Saxender (3 mg / day) Chronic weight management in adults with a BMI of 30 or higher, or a BMI of 27 or higher, and at least one weight-related medical condition in 2014.

Despite the positive results Ancillary editorial, NEJM Editors Julie Ingelfinger and Clifford Rosen, MD, called for and noted gastrointestinal side effects associated with oral semaglutide associated with pancreatitis and rodent thyroid C-cell tumors.

“In the real world, weekly subcutaneous dosing is unlikely to be a palatable and cost-effective solution in the long run,” writes Ingelfinger and Rosen. Instead, daily oral semaglutide may be a more “attractive” option for the patient. They suggested comparing oral GLP-1 agonists with SGLT-2 antagonists in future direct controlled trials and comparing these pharmacological therapies with obesity surgery to assess long-term outcomes.

Kushner for 5 years Effect of Semaglutide on Heart Disease and Stroke in Overweight or Obese Patients (SELECT) The trial is currently underway and additional trials will investigate other important questions related to semaglutide in obese patients.

Novo Nordisk based on the results of the Phase III STEP program Currently seeking marketing approval in the US 2.4 mg semaglutide for chronic weight management.