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Early response to liraglutide predicts long-term weight loss
Early response among patients assigned liraglutide for weight loss was a strong predictor of significant longer-term weight loss in a study recently published in Obesity.
“Early weight loss, whether through lifestyle or pharmacotherapy, is a good predictor of long-term weight loss. Indeed, all recently approved weight-loss medication labels include ‘stopping rules’ stating when pharmacotherapy should be discontinued if clinically relevant weight loss is not, or is unlikely to be, achieved,” Ken Fujioka,MD, of the Scripps Clinic, La Jolla, California, and colleagues wrote. “However, current labels provide little information on outcomes in those individuals eligible for continued treatment beyond the early milestone; reported results are for all randomized individuals.”
Researchers analyzed data from two double blind, placebo-controlled studies: the SCALE Obesity and Prediabetes trial (n = 3,731) and the SCALE Diabetes trial (n = 846). Both studies focused on patients with overweight or obesity and used liraglutide (Saxenda, Novo Nordisk) as an adjunct therapy alongside lifestyle interventions. Fujioka and colleagues evaluated weight loss, quality-of-life changes and changes in cardiometabolic risk factors, classifying early responders as patients who showed at least 4% weight loss by 16 weeks and early non-responders as those who experienced less than 4% weight loss by 16 weeks.
In patients with type 2 diabetes, 62.7% were early responders to a 3-mg dose of liraglutide, compared with 77.3% of patients who did not have diabetes, according to Fujioka and colleagues. Early responders in the SCALE Obesity and Prediabetes trial had a 10.8% (11.2 kg) mean weight loss by 56 weeks, compared with 3% (3.2 kg) for early non-responders. The same was true of the SCALE Diabetes trial; early responders saw a mean 8.5% (9 kg) weight loss vs. 3.1% (3.2 kg) in early non-responders at 56 weeks. Early responders in both trials made up larger proportions of patients who reached at least 5%, more than 10% and more than 15% weight loss by 56 weeks than early non-responders, the researchers wrote. Fujioka and colleagues also reported that greater weight loss was “accompanied by a trend toward greater improvements in cardiometabolic biomarkers.”
“From a clinical perspective, use of the stopping rules should help optimize the use of liraglutide 3.0 mg for weight management,” the researchers wrote. “Patients can be informed that, if they respond well during the first 16 weeks, it is likely they will continue to do so.” – by Andy Polhamus
Disclosure: Fujioka reports fees or grants from Abbott, Eisai, Enteromedics, Gelesis, Nazura, Novo Nordisk, Orexigen Therapeutics, Shire, Takeda and Zafgen. Please see the full study for a complete list of all other authors’ relevant financial disclosures.