Liraglutide 3.0 mg in the treatment of adults with obesity and prediabetes using real‐world UK data: A clinical evaluation of a multi‐ethnic population

Abstract

SummaryUK guidelines recommend liraglutide 3.0 mg in adults treated within specialist weight management services with BMI ≥35 kg/m2, prediabetes and high cardiovascular disease risk. We aimed to clinically evaluate liraglutide 3.0 mg in specialist weight management services. We evaluated liraglutide 3.0 mg in weight management services at Guys and St Thomas' NHS Foundation Trust. Objective body weight (BW) was measured at baseline and 4 months, allowing classification as ‘responders’ (≥5% BW reduction) and ‘non‐responders’ (<5% BW reduction). One hundred and twenty‐one patients were evaluated. At 4 months, 76.0% attended follow‐up (82.6% responders, 17.4% non‐responders); BW (−8.6 kg, 95%CI:‐9.8, −7.4 kg), BMI (−3.2 kg/m2, 95%CI: −3.6, −2.8) and %‐BW (−6.6%, IQR: −8.8%, −5.2%) significantly reduced. In responders, HbA1c reduced by −5.0 mmol/mol (IQR: −7.0. −4.0 mmol/mol). In responders BW continued to reduce up to 12 months (4 m: −10.2 kg, p < .0001; 6 m: −15.6 kg, p < .0001; 9 m: −16.5 kg, p < .0001; 12 m: −16.7 kg, p < .01). Those of Black African and Caribbean ethnicity experienced less BW loss than those of white ethnicity (4.12 kg, p = .017) and had a greater attrition rate. In adults with obesity and prediabetes who are treated within specialist weight management services, liraglutide 3.0 mg reduces BW and HbA1c. Those of Black African and Caribbean ethnicity experienced less BW reduction and greater attrition at 4 months. Further evaluation of the ethnic differences in response to obesity pharmacotherapy is required.

Pharmacovigilance study of GLP-1 receptor agonists for metabolic and nutritional adverse events

“…The weight loss effect produced by liraglutide in previous studies was individualized across subjects, with more significant fat mass reductions in females, and the starting point for measurement of the weight loss effect is recommended to start from baseline ( Santini et al, 2023 ; Schultes et al, 2024 ). Differences in individual specificity and tolerance to GLP-1 RAs may be the main reason for differences in weight loss ( Ruder, 2023 ), with racial differences also contributing ( Dobbie et al, 2024 ). Meanwhile, the recent observation that previous use of anti-obesity medication is associated with poorer weight loss outcomes with semaglutide further expands our knowledge that GLP-1 RAs produce poor weight loss ( Ghusn et al, 2024 ).…”