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Liraglutide reduced body weight in patients with obesity and prediabetes
LAS VEGAS — Patients with obesity who are at risk for prediabetes could lose weight and experience other benefits with injections of liraglutide, according to findings presented at the AACE 23rd Annual Scientific & Clinical Congress.
“Liraglutide 3 mg as an adjunct to diet and exercise was efficacious and generally well-tolerated,” F. Xavier Pi-Sunyer, MD, of St Luke’s-Roosevelt Hospital, said during his presentation. “It was associated with significant benefits in addition to weight loss, including improvement in HbA1c, fasting plasma glucose, blood pressure and fasting lipids.”
Pi-Sunyer and colleagues investigated the effects of liraglutide 3 mg on weight loss in individuals (BMI ≥27 kg/m2 with ≥1 comorbidity or ≥30 kg/m2) who were already on a regimen of diet and exercise over the course of 56 weeks. The researchers looked for mean change in body weight and proportions of individuals losing ≥5% and >10% of body weight.
F. Xavier Pi-Sunyer
The study required that, at a minimum, 30% of the participants had prediabetes. Patients with prediabetes (n=2,285) and patients without prediabetes (n=1,446) followed the same protocol for the first 56 weeks and the data presented here was pooled data.
Participants (age 45.1±12.0 years; 78.5% female; body weight 106.2±21.4 kg; BMI 38.3±6.4 kg/m2; 61.2% with prediabetes) were randomized 2:1 to once-daily subcutaneous liraglutide 3 mg or placebo, in addition to 500 kcal/day deficit diet and exercise. Randomization was stratified by prediabetes status, based on American Diabetes Association 2010 criteria, and BMI.
At week 56, individuals on liraglutide 3 mg had an 8.0% (8.4 kg) reduction in body weight compared to 2.6% (2.8 kg) with placebo; the estimated treatment contrast (ETC) was –5.4% (5.6 kg, P<.0001). A body weight loss ≥5% was seen in 64% of patients treated with liraglutide 3 mg and 27% given placebo (OR=4.8, P<.0001), and a body weight loss >10% was seen in 33% and 10%, respectively (OR=4.3, P<.0001). Individuals receiving treatment also reduced waist circumference (ETC=4.2 cm) and BMI (−2.0 kg/m2) (both P<0.0001) and improved glycemia, blood pressure and lipids.
“There was an interaction analysis that was not significant, showing prediabetes status was not important in terms of weight loss in these individuals,” Pi-Sunyer said.
The most common adverse events with liraglutide were nausea and diarrhea, with onset in the first month; however, most events were mild or moderate and transient, according to Pi-Sunyer. Pancreatitis and gall bladder disorders seen are undergoing further investigation, he added.
For more information: Pi-Sunyer FX. Abstract 700. Presented at: AACE 23rd Annual Scientific & Clinical Congress; May 13-18, 2014; Las Vegas, Nevada.
Disclosures: This work was supported by Novo Nordisk.
Perspective
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A major study unveiled at AACE concerns the weight loss with high-dose liraglutide. Liraglutide is ordinarily usually used at a dose up to about 1.8 mg for diabetes control, but at higher doses, liraglutide produces substantially more weight loss — as much as 10% — and that loss persists for 2 years.