Taking GLP-1 receptor agonist liraglutide (Saxenda) may help patients with bariatric surgery maintain weight loss, a double-blind, placebo-controlled study has been suggested.

In patients who successfully lost at least 25% of their total body weight after bariatric surgery but then regained at least 10%, once-daily liraglutide resulted in an average weight loss of 9.65% from baseline to 56%. Weekly, reports Holly Lofton. , MD, NYU Grosman School of Medicine, New York.

Those randomly selected for placebo continued to regain weight, averaging 1.81% of baseline body weight (Q:<0.00001):

“These patients have already had some success [with surgery-induced weight loss] but then recovered, “Lofton said during the presentation of the results of the ObesityWeek meeting. “We know that this particular surgery has been used since the 1960s, and even in the past, and has been improved by many capable surgeons who do it every day. days for our patients, but we as humans are still prone to metabolic adaptation. “The fact that our bodies really want to lose weight, even as much as we change through surgery and medication, because it is a physiological desire to survive hunger.”

He noted that all patients in the study underwent lifestyle counseling, noting that about 2% of the weight loss observed with placebo occurred even with this intervention.

“The idea of ​​returning this physiological hormone to GLP-1 suggests that we should consider surgery as part of someone’s weight loss treatment, but it does not have to be the last stage,” he added. “Liraglutide may be one of the medications that can help patients move to that next stage, some even exceeding their postoperative rate by using this treatment.”

Liraglutide once daily is approved by the FDA for chronic weight management at a dose of 3 mg / day with a body mass index (BMI) of 30 or higher or ≥ 27 համատեղ in combination with at least one adult lifestyle. Weight-related medical condition. This GLP-1 receptor agonist is also approved for type 2 diabetes at 1.2 mg / day և 1.8 mg / day under the brand name Victoza.

Novo Nordisk also recently had another GLP-1 receptor agonist approved for weight loss when combined with lifestyle management: 2.4 mg semaglutide once a week (Wegovy).

Although less than 5% of patients receiving placebo during this study were able to lose 5% or more of their basal body weight in the postoperative period, the majority of patients with liraglutide, 69%, were able to achieve this goal.

In addition, 48% of patients with liraglutide were able to achieve 10% or more baseline body weight loss compared with patients receiving placebo (Q:<0.0001), և 24% achieved 15% or more of basal body weight loss for 0%, respectively (Q:<0.013):

About a quarter of liraglutide users were able to reach or even exceed their postoperative weight than placebo (Q:= 0.024):

As for cardiometabolic profiles, those who took liraglutide saw a drop in triglyceride levels within 12 months. Although they did not notice a significant change in LDL, HDL, or total cholesterol levels, placebo users reported an increase in LDL և total cholesterol րի triglycerides, as well as a decrease in HDL cholesterol.

The 132 patients included in the study all underwent Roux-en-Y gastric bypass surgery, ranging from 18 to 120 months after surgery (average 68 months). All patients initially lost 25% or more of their total body weight after surgery, but recovered at least 10% or more by gaining their desired weight. All also met the standards of weight management medication.

The mean age of the total cohort was 47. As expected in the case of bariatric surgery cohort, the vast majority were women (87%). More than half were white, and a quarter of each study was black.

Patients were randomized to 2: 1 eggs, 89 of whom received 3.0 mg / day of liraglutide compared with 43 placebo patients. All participants visited the clinic every 3 months from baseline for up to 56 weeks. Participants in both research groups received lifestyle advice from registered nutritionists.

Liraglutide was generally safe and well tolerated. Most of the reported adverse events were presumably related to the gastrointestinal tract, including nausea, constipation, and abdominal pain. 4.5% of patients in the liraglutide group had a severe adverse event, compared with 14% in the placebo group. No deaths were reported in either group during the study.

  • Kristen Monaco is a staff writer focusing on endocrinology, psychiatry and nephrology news. Outside of New York, he has been with the company since 2015.

Discoveries:

Lofton spoke about his relationship with Novo Nordisk, Boehringer Ingelheim և Eli Lilly.