Real-World Clinical Effectiveness of Liraglutide 3.0 mg for Weight Management in Canada

Wharton, Sean; Liu, A; Pakseresht, Arash; Nørtoft, Emil; Haase, CL; Mancini, Johanna; Power, GS; VanderLelie, Sarah; Christensen, RA

doi:10.1016/j.jval.2018.04.1668

Cited by 10 publications

(21 citation statements)

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“…Our results with liraglutide are in line with those observed in the SCALE programme and are consistent with some recent RWS . A retrospective multicentre study in Canada investigated the effectiveness of liraglutide 3.0 mg in 167 people with overweight and obesity .…”

Section: Discussionsupporting

confidence: 91%

Effectiveness and tolerability of orlistat and liraglutide in patients with obesity in a real‐world setting: The XENSOR Study

et al. 2019

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Weight-loss medications (WLMs) may offset the physiological adaptations in appetite and energy expenditure that promote weight regain in patients with obesity after initial weight loss (WL) with lifestyle modification (LSM). 1,2 In essentially all randomised clinical trials (RCTs) of WLMs, the addition of these drugs consistently results in a greater weight reduction than LSM alone. According to clinical guidelines, WLMs should be considered in patients with a BMI ≥30 kg/m 2 or ≥27 kg/m 2 with a weight-related comorbidity when a WL of at least 5% has not been reached after 3-6 months of an LSM programme. 3-5 Until a few years ago, the lipase inhibitor orlistat was the only WLM available in Europe for long-term clinical use.The European Medicines Agency (EMA) approved in 2015 two new drugs: liraglutide 3.0 mg, a glucagon-like peptide-1 (GLP-1) receptor agonist and the combination of the antidepressant bupropion, a dopamine and norepinephrine reuptake inhibitor, with the opioid antagonist naltrexone. In the USA, two other drugs were approved by Summary Aims: To evaluate in a real-world setting the effectiveness of two drugs, orlistat and liraglutide, in patients with overweight or obesity and insufficient weight loss (WL) after a lifestyle modification programme. Methods:Retrospective, observational cohort study comparing clinical outcomes of orlistat 120 mg three times a day and liraglutide (up to 3 mg daily) in adult patients with BMI ≥30 kg/m 2 or ≥27 kg/m 2 with at least a weight-related comorbidity who had failed to lose at least 5% of their weight after 6 months of lifestyle modification.The co-primary end-points, assessed at 3-6 months and at the end of the follow-up, were weight change from baseline, proportion of patients who lost at least 5% of their baseline weight and adjusted differences in WL between both drugs.Results: Five hundred patients, 400 in the group of orlistat (age 47.0, weight 107.8 kg) and 100 in the group of liraglutide (age 51.9 years, weight 105.1 kg), were included.Treatment with both drugs significantly reduced weight, fasting plasma glucose, systolic BP, low-density lipoprotein-cholesterol and alanine transaminase over a median follow-up period of 7 months. WL with liraglutide (−7.7 kg) was significantly greater than that observed with orlistat (−3.3 kg), and more individuals lost at least 5% of their baseline weight with liraglutide (64.7%) than with orlistat (27.4%). Rates of prediabetes significantly decreased with liraglutide in comparison to orlistat. Conclusions:In this real-world study, liraglutide showed a greater effectiveness in WL compared with orlistat and improved several obesity-associated metabolic and cardiovascular risk factors.

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Section: Discussionsupporting

confidence: 91%

Effectiveness and tolerability of orlistat and liraglutide in patients with obesity in a real‐world setting: The XENSOR Study

et al. 2019

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“…The medical doctor examines and reviews the patient's medical history, discusses pharmaceutical management or surgical intervention where clinically indicated. Patients who choose to initiate liraglutide 3.0 mg are recommended to follow a dosing schedule starting at 0.6 mg that is titrated 0.6 mg/mL until reaching the maximum clinical dosage of 3.0 mg, but this may vary in clinical practice . The physician orders blood work, resting metabolic rate test and other relevant tests for each patient.…”

Section: Methodsmentioning

confidence: 99%

Liraglutide 3.0 mg for the management of insufficient weight loss or excessive weight regain post‐bariatric surgery

et al. 2019

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Summary To assess the effectiveness of liraglutide 3.0 mg in post‐bariatric surgery patients, and to determine whether this would differ based on the type of bariatric surgery. One hundred seventeen post‐bariatric surgery patients from the Wharton Medical Clinic were analysed. Changes in weight while taking liraglutide 3.0 mg were examined for all patients, and by three types of bariatric surgery—Roux‐en‐Y gastric bypass, gastric banding and gastric sleeve. Patients primarily underwent Roux‐en‐Y gastric bypass (n = 53, 45.3%) or gastric banding (n = 50, 42.7%). Over 7.6 ± 7.1 months taking liraglutide 3.0 mg, patients lost a statistically significant amount of weight (−6.3 ± 7.7 kg, P < .05) regardless of the type of surgery they had (P > .05). This decrease in weight remained significant after 1‐year of taking liraglutide 3.0 mg (P < .05). Nausea was the most prevalent side effect, reported by 29.1% patients. While options for excess weight management in post‐bariatric surgery patients are limited, results of this study suggest that post‐bariatric surgery patients can lose a significant amount of weight while taking liraglutide 3.0 mg regardless of the type of surgery they had. Further, similar to non‐surgical populations, post‐bariatric surgery patients taking liraglutide 3.0 mg may experience gastrointestinal side effects such as nausea and can continue to lose weight up to 1 year.

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“…Persistence (defined in this study as the period of time from treatment initiation to patient-reported discontinuation, loss of patient to follow-up including if >90 days lapsed between follow-up visits, or study end) with liraglutide 3.0 mg overall and persistence for at least 4 and 6 months were assessed, in line with the time points specified in the primary study. 13 Associations among SaxendaCare ® enrollment, persistence and weight loss in all patients with available data were also investigated.…”

Section: Methodsmentioning

confidence: 99%

“…12 A RWE study of data from six weight management clinics in Canada, showing that patients on liraglutide 3.0 mg lost a mean of 7.1% (standard deviation [SD] 5.4%) body weight after 6 months of treatment, has been previously reported by this research team. 13 The current study reports a secondary analysis that expands on medication persistence findings and investigates the associations between enrollment in the patient support program SaxendaCare ® and both persistence with liraglutide 3.0 mg and weight loss.…”

mentioning

confidence: 99%

Real‐world persistence with liraglutide 3.0 mg for weight management and the SaxendaCare® patient support program

Wharton¹,

Haase

Kamran³

et al. 2020

Obesity Science & Practice

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Summary Objective Weight management medications can significantly increase patients' chances of achieving a clinically meaningful weight loss if patients persist with treatment. This retrospective observational study of de‐identified medical records of 311 patients is the first real‐world study examining persistence with liraglutide 3.0 mg in Canada, and also investigates associations between the SaxendaCare® patient support program and persistence and weight loss. Methods Overall persistence was assessed, as well as associations of enrollment in SaxendaCare®, persistence and weight loss. Results Overall mean (standard deviation) persistence with liraglutide 3.0 mg was 6.3 (4.1) months, and 67.5% (n = 210) and 53.7% (n = 167) of patients persisted for ≥4 and ≥ 6 months, respectively. Enrollment in SaxendaCare® was associated with significantly longer persistence with liraglutide 3.0 mg and greater weight loss. Patients enrolled in SaxendaCare® (n = 119) persisted for 7.9 (4.0) versus 5.2 (3.8) months for those not enrolled (n = 184) (p < 0.001), and had significantly greater percent weight loss after 6 months regardless of the duration of their persistence (−7.9% vs −5.5% from baseline, p < 0.01). Conclusions These findings suggest that, in clinical settings, persistence with liraglutide 3.0 mg can exceed 6 months, and that enrolling in SaxendaCare® may be associated with comparatively longer persistence and, regardless of persistence, greater weight loss.

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Real-World Clinical Effectiveness of Liraglutide 3.0 mg for Weight Management in Canada

Cited by 10 publications

References 0 publications

Effectiveness and tolerability of orlistat and liraglutide in patients with obesity in a real‐world setting: The XENSOR Study

Effectiveness and tolerability of orlistat and liraglutide in patients with obesity in a real‐world setting: The XENSOR Study

Liraglutide 3.0 mg for the management of insufficient weight loss or excessive weight regain post‐bariatric surgery

Real‐world persistence with liraglutide 3.0 mg for weight management and the SaxendaCare® patient support program

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