Liraglutide Effective for Weight Regain After Gastric Bypass
The glucagon-like peptide-1 (GLP-1) receptor agonist liraglutide (Saxenda, Novo Nordisk) changed into secure and robust for treating weight regain after Roux-en-Y gastric bypass (RYGB) in a randomized managed trial.
That is, 132 sufferers who had misplaced at the least 25% in their preliminary weight after RYGB, after which they received at the least ten�CK were randomized 2:1 to acquire liraglutide plus standard lifestyle recommendation a registered dietitian or lifestyle recommendation on my own.
After 12 months, 69%, forty-eight%, and 24% of sufferers who had obtained liraglutide were misplaced at the most minor 5%, 10%, and 15% in their examine access weight, respectively. In contrast, the most effective 5% of sufferers within the managed institution misplaced at the least 5% of their weight, and none lost at the least 10% of their weight.
“Liraglutide three. Zero mg/day, with lifestyle modification, changed into extensively extra powerful than placebo in treating weight regain after RYGB without the extended threat of great destructive events,” Holly F. Lofton, MD, summarized this week in an oral consultation on the digital ObesityWeek® 2021 meeting.
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Lofton, a scientific companion professor of surgical treatment and medicine, and director, weight control program, NYU, Langone Health, New York City, defined to Medscape Medical News that she initiated the examination after attending a “packed” consultation approximately publish bariatric surgical treatment weight regain at a previous American Society of Metabolic and Bariatric Surgery conference.
“The teachers encouraged conservative measures (together with reiterating the food regimen recommendations, exercise, [and] counseling), and revisional surgeries,” she stated in an email, however on time, “there has been no literature that furnished path on which pharmacotherapies are nice for this population.”
It changed into recognized that decreases in endogenous GLP-1 degrees coincide with weight regain, and liraglutide (Saxenda) transformed into the most effective GLP-1 agonist authorized for persistent weight control on time. Hence, she devised the cutting-edge examination protocol.
The findings are particularly beneficial for sufferers who aren’t applicants for bariatric surgical treatment revisions, she noted. Further studies are wanted to research the impact of more modern GLP-1 agonists, together with semaglutide (Wegovy), on weight regain following exceptional styles of bariatric surgical treatment.
Dr. Wendy C. King
Asked to comment, Wendy C. King, Ph.D., who changed into now no longer concerned with this studies, stated that extra than thirds of sufferers dealt with three mg/day subcutaneous liraglutide injections withinside the cutting-edge examine misplaced at the least 5% in their preliminary weight a 12 months later, and 20% of them attained a weight as little as, or decrease than, their lowest weight after bariatric surgical treatment (nadir weight).
“The truth that each corporation obtained lifestyle counseling from registered dietitians for simply over 12 months, however most effective sufferers withinside the liraglutide institution misplaced weight, on average, speaks to the issue of dropping weight following weight regain publish-bariatric surgical treatment,” brought King, a companion professor of epidemiology on the University of Pittsburgh, in Pennsylvania.
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This examination “affords statistics which can assist clinicians and sufferers recognize the capacity impact of including liraglutide three. zero mg/day to their weight reduction efforts,” she instructed Medscape Medical News in an email.
However, “Given that 42% of these on liraglutide stated gastrointestinal-associated aspect results, sufferers need to additionally be recommended in this capacity final results and given recommendations for a way to reduce such aspect results,” King suggested.
Weight Regain Common, Repeat Surgery Entails Risk
Weight regain is not an unusual place even years after bariatric surgical treatment. Repeat surgical treatment includes a few threats, and lifestyle techniques on my own are hardly ever successful in reversing weight regain, Lofton instructed the audience.
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The researchers enrolled 132 adults who had a median weight of 134 kg (295 pounds) after they underwent RYGB and who misplaced at the least 25% in their preliminary weight (suggest weight reduction of 38%) after the surgical treatment; however, who additionally regained at the least 10% in their initial weight.
At enrollment of the cutting-edge examine (baseline), the sufferers had RYGB 18 months to ten years earlier (suggest 5.7 years earlier) and now had a median weight of ninety-nine kg (218 pounds) and a median BMI of 35.6 kg/m2. None of the sufferers had diabetes.
The sufferers have been randomized to acquire liraglutide (n = 89, 84% women) or placebo (n = 43, 88% women) for fifty six weeks.
They have a median age of forty-eight years, and approximately 59% have been White, and 25% have been Black.
All sufferers had hospital visits every three months wherein they obtained lifestyle counseling from a registered dietitian.
At 12 months, sufferers within side the liraglutide institution had misplaced a median of 8.8% in their baseline weight, while the ones within side the placebo institution had received a median of 1. forty-eight% in their baseline weight.
There have been no enormous between-institution variations in cardiometabolic variables.
None of the sufferers within side the managed institution attained a weight that changed into as little as their nadir weight after RYGB.
The quotes of nausea (25%), constipation (16%), and stomach pain (10%) within side the liraglutide institution have been better than within side the placebo institution (7%, 14%, and 5%, respectively); however, much like quotes of gastrointestinal aspect results in different trials of this agent.
Lofton has disclosed receiving consulting prices, being on a speaker bureau for Novo Nordisk, and receiving studies budget from Boehringer Ingelheim, Eli Lilly, and Novo Nordisk. King has stated no functional economic relationships.
Obesity Week® 2021. Presented November 2, 2021.
https://www.medscape.com/viewarticle/962388?src=#vp_2
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