About 45% of teens with obesity improve to overweight or normal weight with semaglutide
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Key takeaways:
- Of adolescents with obesity receiving semaglutide in the STEP TEENS trial, 44.9% improved to overweight or normal weight.
- The odds of improving BMI category with semaglutide were 23 times higher than placebo.
Nearly half of adolescents with obesity receiving once-weekly subcutaneous semaglutide achieved overweight or normal weight at 68 weeks, according to data from the STEP TEENS trial presented during the European Congress on Obesity.
“Semaglutide treatment increased the odds of dropping below the clinical cut point for obesity by about 23-fold in adolescents,” Aaron S. Kelly, PhD, co-director of the University of Minnesota Center for Pediatric Obesity Medicine, told Healio. “Nearly 45% of those assigned to semaglutide in the trial were able to move down into either the overweight or normal-weight BMI categories.”
As Healio previously reported, adolescents with obesity who received semaglutide (Wegovy, Novo Nordisk) in the phase 3a STEP TEENS trial lost 16.1% of their body weight at 68 weeks. In December 2022, the FDA approved a new indication for semaglutide to allow its use among adolescents aged 12 to 17 years with a BMI in the 95th percentile or higher for age and sex.
In new data presented at the European Congress on Obesity and simultaneously published in Obesity, Kelly and colleagues conducted a post hoc analysis of data from STEP TEENS to analyze the change in BMI category among participants. Adolescents in the study were randomly assigned to 2.4 mg semaglutide once weekly or placebo, along with lifestyle intervention consisting of healthy nutrition and a goal of 60 minutes of moderate- to high-intensity exercise per day. CDC BMI growth charts were used to categorize participants by obesity severity. Class I obesity was defined as having a BMI between 95% and 120% of the 95th percentile, class II obesity was a BMI between 120% and 140% of the 95th percentile, and class III obesity was defined as a BMI in the 140% or higher of the 95th percentile. Normal weight was defined as having a BMI between the 5th and 85th percentile, and overweight was between the 85th and 95th BMI percentile. Improvement in a BMI category was classified as being in a lower obesity class at 68 weeks compared with baseline.
There were 118 adolescents in the semaglutide group and 58 in the placebo group included in the post hoc analysis. The semaglutide group had a higher proportion of participants achieve normal weight or overweight compared with placebo (44.9% vs. 12.1%). When the trial product estimand was assessed, semaglutide was associated with a greater likelihood for achieving normal weight or overweight than placebo (OR = 22.7; 95% CI, 7.6-67.9; P < .0001).
From baseline to 68 weeks, the percentage of adolescents in the semaglutide group with class III obesity declined from 37.3% to 13.6%, the percentage with class II obesity decreased from 31.4% to 19.5%, and the proportion with class I obesity dropped from 31.4% to 22%. The placebo group had an increase in participants with class III obesity, from 19% to 22.4%, whereas the percentage with class I obesity declined from 39.7% to 32.8% and the proportion with class II obesity dropped from 41.4% to 32.8%. The odds for achieving a BMI category improvement were greater with semaglutide than placebo (OR = 23.5; 95% CI, 9.9-55.5; P < .0001). Of the semaglutide group, 44.9% improved by at least two BMI categories from baseline to 68 weeks compared with 3.4% of the placebo group.
Kelly said the findings from STEP TEENS are “unprecedented” for obesity treatments other than bariatric surgery and that the BMI improvement greatly exceeds the average response with lifestyle therapy alone.
“Clinically, this gives pediatric health care providers a new perspective regarding how likely it is that their adolescent patient will achieve meaningful weight loss with semaglutide treatment,” Kelly said. “These data underscore the high degree of effectiveness of semaglutide in the adolescent population.”
Reference:
Kelly AS, et al. Obesity. 2023;doi:10.1002/oby.23808.
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Kelly AS, et al. Oral Presentation AD06.04. Presented at: European Congress on Obesity; May 17-20, 2023; Dublin.
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