Early weight loss with liraglutide 3.0 mg is a good predictor of clinically meaningful weight loss after 56 weeks

Blueher, Matthias; Wehrhahn, T; Hermansen, Kjeld; Greenway, Frank L.; Fujioka, Ken; Donsmark, Morten; Jensen, Christine C.; Wilding, Jph

doi:10.1055/s-0036-1580953

Cited by 2 publications

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“…Согласно данным M. Blüher и соавт., предикто-ром снижения исходного веса на 10% и более к 56-й неделе терапии является его снижение на 5% и более через 16 недель от старта применения лираглутида. При этом при пролонгации терапии лираглутидом 3,0 мг у лиц, не продемонстрировавших раннего ответа через 3 месяца, снижение массы тела через 1 год использования препарата не превышает значения в 10% от исходной [9]. Факторы, позволяющие прогнозировать ранний ответ (то есть снижение массы тела на 5% и более через 16 недель) на терапию лираглутидом у пациентов с экзогенно-конституциональным ожирением, на текущий момент не установлены.…”

Section: обоснованиеunclassified

Prediction of early response to liraglutide therapy in patients with obesity

et al. 2020

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BACKGROUND: The main goal of treating obesity is to reduce the risk of developing its complications and comorbid diseases, which requires a steady decrease in body weight by at least 510%. In Russia in 2016, the list of drugs for the treatment of obesity was supplemented by a glucagon-like peptide 1 receptor agonist (GLP-1) liraglutide . There is evidence that about one third of patients do not achieve a clinically significant decrease in body weight during treatment with liraglutide, while the factors that predict the so-called early response to treatment are currently unknown. AIM: To identify prognostic factors of an early response to complex therapy of exogenously constitutional obesity, including agonist of GLP-1 receptors liraglutide, and to evaluate the effect of this therapy on the dynamics of levels of endogenous peptide bioregulators of eating behavior (IB). MATERIALS AND METHODS: The study included 42 patients with exogenously constitutional obesity, which were divided into 2 groups, comparable by sex, age and body mass index (BMI). The first group (n=22) received treatment recommendations for the correction of nutrition and physical activity, as well as liraglutide 3.0 mg for 3 months. The second group (n=20) received only recommendations for the correction of nutrition and physical activity. At the start and after 3 months, anthropometric characteristics and laboratory parameters were evaluated in all patients, including the levels of endogenous peptide bioregulators of IB (leptin, ghrelin, obestatin and GLP-1), their dynamics was compared between groups. Depending on the therapeutic effect, the 1st group was divided into two subgroups: those who achieved (n = 14) and did not achieve (n = 8) a clinically significant decrease in body weight. In both subgroups, baseline characteristics were analyzed as possible prognostic factors for the effectiveness of complex therapy. RESULTS: To predict an early response to complex therapy, including liraglutide, a mathematical model has been developed that is implemented as a calculator in MS Excel and contains a combination of initial body weight and fasting plasma ghrelin. The dynamics of body weight and BMI in the group of complex therapy was statistically significantly higher than that in the group of isolated lifestyle modifications (ILM). CONCLUSIONS: The proportion of individuals with an early response to 3.0 mg liraglutide therapy is comparable to that of data from randomized clinical trials. The mathematical model, which includes a combination of initial body weight and plasma ghrelin, allows predicting the likelihood of a clinically significant decrease in body weight after 3 months of using liraglutide 3.0 mg in combination with ILM with a sensitivity of 86% [65%; 97%] and prognostic value of a positive result of 80% [60%; 95%].

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Section: обоснованиеunclassified

Prediction of early response to liraglutide therapy in patients with obesity

et al. 2020

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“…Individuals who have not lost ≥5% of baseline weight after 12 weeks of intended clinical dose are considered ‘non‐responders’ and the treatment should be stopped (according to the EMA stopping rule), whereas individuals achieving this clinically meaningful weight loss target after 12 weeks at intended clinical dose are considered ‘responders’. For example, in the Satiety and Clinical Adiposity – Liraglutide Evidence (SCALE) in individuals with and without diabetes Obesity and Prediabetes trial, the proportion of all subjects (responders and non‐responders) achieving a ≥5% weight loss at week 56 with liraglutide 3.0 mg was 63.2% ( versus 27.1% with placebo) but was 88.2% for responders ( versus 36.9% for non‐responders) . This type of analysis may better describe the likely real‐world effectiveness, assuming the stopping rule is followed.…”

Section: Will the Recently Approved Aoms Change Weight Management Pramentioning

confidence: 99%

Beyond lifestyle interventions: exploring the potential of anti‐obesity medications in the UK

Wilding

2018

Clinical Obesity

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SummaryIn the UK, over one‐quarter of the adult population have obesity (body mass index ≥30 kg m−2). This has major implications for patients’ health and the National Health Service. Despite published studies showing that significant weight loss can be achieved and maintained in primary care, and guidance from the National Institute for Health and Care Excellence, weight management services are inconsistently implemented. This may be due primarily to workload and financial constraints. There is also a lack of belief that specialist weight management services and anti‐obesity medications (AOMs) are a viable alternative to bariatric surgery for long‐term maintenance of weight loss. This article discusses the challenges facing obesity management and explores the reasons for the lack of investment in AOMs in the UK to date. The aim of this article is to identify whether the newer AOMs, such as naltrexone/bupropion and liraglutide 3.0 mg, are likely to perform better in a real‐world setting than current or withdrawn AOMs. In addition, it considers whether the equitable provision of specialist weight management services and future clinical trial design could be improved to help identify those individuals most likely to benefit from AOMs and, thus, improve outcomes for people with obesity in the UK.

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Early weight loss with liraglutide 3.0 mg is a good predictor of clinically meaningful weight loss after 56 weeks

Cited by 2 publications

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Prediction of early response to liraglutide therapy in patients with obesity

Prediction of early response to liraglutide therapy in patients with obesity

Beyond lifestyle interventions: exploring the potential of anti‐obesity medications in the UK

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