Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity

Ghusn, Wissam; Rosa, Alan De la; Sacoto, Daniel; Cifuentes, Lizeth; Campos, Alejandro; Feris, Fauzi; Hurtado, Maria D.; Acosta, Andrés

doi:10.1001/jamanetworkopen.2022.31982

Cited by 103 publications

(95 citation statements)

References 40 publications

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“…The attenuated weight-loss performance of semaglutide alone may speak to the importance of implementing these lifestyle interventions concurrently with semaglutide prescription. In addition, adherence has been much more strongly confirmed in previous studies [6,[30][31][32], whereas our study relied only on EHR records of prescription as measure of semaglutide use. Additionally, some previous studies had majority female participants [30][31][32].…”

Section: Observed Weight Losssupporting

confidence: 70%

“…In addition, adherence has been much more strongly confirmed in previous studies [6,30‐32], whereas our study relied only on EHR records of prescription as measure of semaglutide use. Additionally, some previous studies had majority female participants [30‐32]. The near equivalent number of male and female patients in our study may have contributed to lower overall weight reduction.…”

Section: Discussionsupporting

confidence: 58%

“…This study also focused on individuals with a 0.25 to 2 mg weekly dose of semaglutide. The dosage used in the clinical trials to treat obesity was higher 1.7 or 2.4 mg doses [30]. We did not include records of the 2.4 mg dosage in the present study because of inadequate accumulation of records from FDA approval in 2021 to the end of our study window in March 2022, which could have contributed to more modest weight‐loss performance of individuals taking semaglutide.…”

Section: Discussionmentioning

confidence: 99%

“…Using the top 20 important features from our SHAP value analysis, we fit a parsimonious logistic regression model and reported adjusted ORs. All analyses were conducted in Python 3.7.017 using open-source packages [26][27][28][29][30][31].…”

Section: Predictive Modeling and Risk Factor Discoverymentioning

confidence: 99%

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

Powell,

Song,

Mohamed

et al. 2023

Obesity

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ObjectiveApproved by the Food and Drug Administration (FDA) in 2017 for diabetes and in 2021 for weight loss, semaglutide has seen widespread use among individuals who aim to lose weight. The aim of this study was to evaluate weight loss and the influence of clinical factors on semaglutide patients in real‐world clinical practice.MethodsUsing data from 10 health systems within the Greater Plains Collaborative (a PCORnet Clinical Research Network), nearly 4000 clinical factors encompassing demographic, diagnosis, and prescription information were extracted for semaglutide patients. A gradient‐boosting, machine‐learning classifier was developed for weight‐loss prediction and identification of the most impactful factors via SHapley Additive exPlanations (SHAP) value extrapolation.ResultsA total of 3555 eligible patients (539 of whom were observed 52 weeks following exposure) from March 2017 to April 2022 were studied. On average, individuals lost 4.44% (male individuals, 3.66%; female individuals, 5.08%) of their initial weight. History of diabetes mellitus diagnosis was associated with less weight loss, whereas prediabetes and linaclotide use were associated with more pronounced weight loss.ConclusionsWeight loss in patients prescribed semaglutide from real‐world evidence was strong but attenuated compared with previous clinical trials. Machine‐learning analysis of electronic health record data identified factors that warrant further research and consideration when tailoring weight‐loss therapy.

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Section: Observed Weight Losssupporting

confidence: 70%

Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Predictive Modeling and Risk Factor Discoverymentioning

confidence: 99%

See 2 more Smart Citations

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

Powell,

Song,

Mohamed

et al. 2023

Obesity

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“…Exercise has a positive effect on weight maintenance by preserving muscle mass and overall benefits bone tissue. ( 104 ) Therefore, robust evidence is needed regarding the impact on body composition. Moreover, the specific doses or dose–response effects of GLP‐1 RAs on bone health have not been thoroughly investigated, especially when considering the higher dosages used for weight loss compared to the treatment of T2D.…”

Section: Discussionmentioning

confidence: 99%

Effects of Incretin Therapy on Skeletal Health in Type 2 Diabetes—A Systematic Review

Viggers,

Rasmussen,

Vestergaard

2023

JBMR Plus

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Diabetes poses a significant risk to bone health, with Type 1 diabetes (T1D) having a more detrimental impact than Type 2 diabetes (T2D). The group of hormones known as incretins, which includes gastric inhibitory peptide (GIP) and glucagon‐like peptide 1 (GLP‐1), play a role in regulating bowel function and insulin secretion during feeding. GLP‐1 receptor agonists (GLP‐1 RAs) are emerging as the primary treatment choice in T2D, particularly when atherosclerotic cardiovascular disease is present. Dipeptidyl peptidase 4 inhibitors (DPP‐4is), although less potent than GLP‐1 RAs, can also be used. Additionally, GLP‐1 RAs, either alone or in combination with GIP, may be employed to address overweight and obesity. Since feeding influences bone turnover, a relationship has been established between incretins and bone health. To explore this relationship, we conducted a systematic literature review following the PRISMA guidelines. While some studies on cells and animals have suggested positive effects of incretins on bone cells, turnover, and bone density, human studies have yielded either no or limited and conflicting results regarding their impact on bone mineral density (BMD) and fracture risk. The effect on fracture risk may vary depending on the choice of comparison drug and the duration of follow‐up, which was often limited in several studies. Nevertheless, GLP‐1 RAs may hold promise for people with T2D who have multiple fracture risk factors and poor metabolic control. Furthermore, a potential new area of interest is the use of GLP‐1 RAs in fracture prevention among overweight and obese people. Based on this systematic review, existing evidence remains insufficient to support a positive or a superior effect on bone health to reduce fracture risk in people with T2D. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

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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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Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity

Cited by 103 publications

References 40 publications

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

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

Effects of Incretin Therapy on Skeletal Health in Type 2 Diabetes—A Systematic Review

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

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