Medications and conditions associated with weight loss in patients prescribed semaglutide based on real‐world data

Powell, William; Song, Xing; Mohamed, Yahia; Walsh, Dave; Parks, Elizabeth J.; McMahon, Tamara M.; Khan, Mirza; Waitman, Lemuel R.

doi:10.1002/oby.23859

Cited by 7 publications

(2 citation statements)

References 37 publications

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“…Further improvement in glycemia and weight elicited with this combination therapy exceeds effects observed in other real-world studies among those who switched to injectable semaglutide from less potent GLP-1 [ 33 , 34 ]. Further, the weight loss achieved with carbohydrate restriction and GLP-1 combination therapy was on par or greater than weight loss observed in STEP 2 among people with T2D treated with 2.4 mg and 1.0 mg semaglutide [ 10 ] and in the real world across 10 clinics [ 35 ], suggesting there may be benefit to pairing GLP-1 with CRNT therapy to achieve greater weight loss when clinically indicated or to enable greater weight loss when higher doses are poorly tolerated.…”

Section: Discussionmentioning

confidence: 99%

Impact of Glucagon-Like Peptide 1 Agonist Deprescription in Type 2 Diabetes in a Real-World Setting: A Propensity Score Matched Cohort Study

McKenzie,

Athinarayanan

2024

Diabetes Ther

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Introduction Glucagon-like peptide 1 receptor agonists (GLP-1) elicit substantial reductions in glycemia and body weight in people with type 2 diabetes (T2D) and obesity, but existing data suggest the therapy must be continued indefinitely to maintain clinical improvements. Given the high cost and poor real-world persistence of GLP-1, an effective therapy that enables deprescription with sustained clinical improvements would be beneficial. Thus, the purpose of this real-world study was to assess the effect of GLP-1 deprescription on glycemia and body weight following co-therapy with carbohydrate restricted nutrition therapy (CRNT) supported via telemedicine in a continuous remote care model. Methods A retrospective, propensity score matched cohort study among patients with T2D at a telemedicine clinic was conducted. Patients in whom GLP-1 were deprescribed (DeRx; n = 154) were matched 1:1 with patients in whom GLP-1 were continued (Rx). HbA1c and body weight at enrollment in clinic (pre-CRNT), at date of deprescription or index date (derx/ID), and at 6 and 12 months (m) post-derx/ID were utilized in this study. Results No regression in weight was observed following deprescription with > 70% maintaining ≥ 5% weight loss 12 m post-derx/ID. HbA1c rose 6 m and 12 m post-derx/ID in both DeRx and Rx cohorts, but most patients maintained HbA1c < 6.5%. HbA1c and body weight measured 6 m and 12 m following derx/ID did not significantly differ between cohorts and were improved at derx/ID and at follow-up intervals compared to pre-CRNT. Conclusion These results demonstrate the potential for an alternate therapy, such as CRNT supported via telemedicine, to enable maintenance of weight loss and glycemia below therapeutic targets following discontinuation of GLP-1 therapy. Supplementary Information The online version contains supplementary material available at 10.1007/s13300-024-01547-0.

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Section: Discussionmentioning

confidence: 99%

Impact of Glucagon-Like Peptide 1 Agonist Deprescription in Type 2 Diabetes in a Real-World Setting: A Propensity Score Matched Cohort Study

McKenzie,

Athinarayanan

2024

Diabetes Ther

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“…Furthermore, despite the compelling evidence of the benefits of GLP-1RAs as adjunct treatments to intensive behavioral therapy in weight management and their currently anecdotal effect on managing food noise, these drugs should not be regarded as standalone treatments, and care should be exercised when prescribing such pharmacological treatments and monitoring patients receiving them. As discussed by Powell et al [90], semaglutide may display suboptimal results in real-world settings when used in isolation without the use of interventions to promote lifestyle changes, such as nutrition and psychological counseling, and adequate support to increase levels of physical activity. Additionally, concerns regarding a possible link between semaglutide use and depressive symptoms and suicidal ideation have recently emerged through case reports [91].…”

Section: Research and Public Health Implicationsmentioning

confidence: 99%

What Is Food Noise? A Conceptual Model of Food Cue Reactivity

Hayashi,

Edwards,

Emond

et al. 2023

Nutrients

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As GLP-1 receptor agonists, like semaglutide, emerge as effective treatments for weight management, anecdotal reports from patients and clinicians alike point to a reduction in what has been colloquially termed “food noise”, as patients report experiencing less rumination and obsessive preoccupation about food. In this narrative review, we discuss concepts used in studies to investigate human eating behavior that can help elucidate and define food noise, particularly food cue reactivity. We propose a conceptual model that summarizes the main factors that have been shown to determine the magnitude of the reactivity elicited by external and internal food cues and how these factors can affect short- and long-term behavioral and clinical outcomes. By integrating key research conducted in this field, the Cue–Influencer–Reactivity–Outcome (CIRO) model of food cue reactivity provides a framework that can be used in future research to design studies and interpret findings related to food noise and food cue reactivity.

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One-Year Weight Reduction With Semaglutide or Liraglutide in Clinical Practice

Gasoyan,

Pfoh,

Schulte

et al. 2024

JAMA Netw Open

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ImportanceLimited data are available on long-term weight loss achieved with semaglutide or liraglutide for type 2 diabetes (T2D) or obesity in clinical practice.ObjectiveTo document weight loss achieved with injectable forms of semaglutide or liraglutide and identify factors associated with weight reduction of 10% or greater at 1 year.Design, Setting, and ParticipantsThis retrospective cohort study used electronic health records from a large, integrated health system in Ohio and Florida. Participants included adults with a body mass index (calculated as the weight in kilograms divided by the height in meters squared) of at least 30.0 who initiated treatment with semaglutide or liraglutide between July 1, 2015, and June 30, 2022. Follow-up was completed July 28, 2023.ExposureInjectable forms of semaglutide or liraglutide approved for T2D or obesity.Main Outcomes and MeasuresPercentage weight change and categorical weight reduction of 10% or greater at 1 year.ResultsA total of 3389 patients (mean [SD] age, 50.4 [12.2] years; 1835 [54.7%] female) were identified. Of these, 1341 patients received semaglutide for T2D; 1444, liraglutide for T2D; 227, liraglutide for obesity; and 377, semaglutide for obesity. Mean (SD) percentage weight change at 1 year was −5.1% (7.8%) with semaglutide vs −2.2% (6.4%) with liraglutide (P &lt; .001); −3.2% (6.8%) for T2D as a treatment indication vs −5.9% (9.0%) for obesity (P &lt; .001); and −5.5% (7.5%) with persistent medication coverage (ie, a cumulative gap of less than 90 days) at 1 year vs −2.8% (7.0%) with 90 to 275 medication coverage days and −1.8% (6.7%) with fewer than 90 medication coverage days (P &lt; .001). In the multivariable model, semaglutide vs liraglutide (adjusted odds ratio [AOR], 2.19 [95% CI, 1.77-2.72]), obesity as a treatment indication vs T2D (AOR, 2.46 [95% CI, 1.83-3.30]), persistent medication coverage vs 90 medication coverage days (AOR, 3.36 [95% CI, 2.52-4.54]) or 90 to 275 medication coverage days within the first year (AOR, 1.50 [95% CI, 1.10-2.06]), high dosage of the medication vs low (AOR, 1.58 [95% CI, 1.11-2.25]), and female sex (AOR, 1.57 [95% CI, 1.27-1.94]) were associated with achieving a 10% or greater weight reduction at year 1.Conclusions and RelevanceIn this retrospective cohort study of 3389 patients with obesity, weight reduction at 1 year was associated with the medication’s active agent, its dosage, treatment indication, persistent medication coverage, and patient sex. Future research should focus on identifying the reasons for discontinuation of medication use and interventions aimed at improving long-term persistent coverage.

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Medications and conditions associated with weight loss in patients prescribed semaglutide based on real‐world data

Cited by 7 publications

References 37 publications

Impact of Glucagon-Like Peptide 1 Agonist Deprescription in Type 2 Diabetes in a Real-World Setting: A Propensity Score Matched Cohort Study

Impact of Glucagon-Like Peptide 1 Agonist Deprescription in Type 2 Diabetes in a Real-World Setting: A Propensity Score Matched Cohort Study

What Is Food Noise? A Conceptual Model of Food Cue Reactivity

One-Year Weight Reduction With Semaglutide or Liraglutide in Clinical Practice

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