Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity

Rubino, Domenica; Abrahamsson, Niclas; Davies, Melanie J.; Hesse, Dan; Greenway, Frank L.; Jensen, Camilla; Lingvay, Ildiko; Mosenzon, Ofri; Rosenstock, Julio; Rubio, Miguel A.; Rudofsky, Gottfried; Tadayon, Sayeh; Wadden, Thomas A.; Dicker, Dror; Investigators, Step

doi:10.1001/jama.2021.3224

Cited by 572 publications

(576 citation statements)

References 37 publications

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“…The safety and efficacy of once-weekly-administered semaglutide 2.4 mg for obesity have been assessed and published in four phase 3, 68-week trials (STEP clinical program) [90][91][92][93]. The STEP 1 trial focused on the use of semaglutide 2.4 mg as an adjunct to lifestyle intervention [90].…”

Section: Use Of Other Glp-1 Ra Therapy In Obesitymentioning

confidence: 99%

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Patient initiation and maintenance of GLP-1 RAs for treatment of obesity

Patel

Smith

2021

Expert Review of Clinical Pharmacology

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Introduction: Healthcare providers (HCPs) see many patients with obesity-related complications and are therefore well placed to help treat obesity itself. However, limited collated information exists to help HCPs with the practical use of anti-obesity medications (AOMs). We focus on the initiation and maintenance of a glucagon-like peptide-1 receptor agonist (GLP-1 RA) for weight management, liraglutide 3.0 mg. Literature search was conducted between 25-28 November 2019 on PubMed and ClinicalTrials.gov. Areas covered: Clinical trial and real-world data describing weight-loss efficacy, cardiometabolic risk factors, incidence of adverse events (AEs), and persistence are presented to assist HCPs with patient discussions. Practical considerations to overcome barriers to optimal use are provided, equipping HCPs with the information required to aid with adherence to and persistence with AOMs. The use of other GLP-1-RA therapies in obesity is discussed in light of the recent US Food and Drug Administration approval of semaglutide 2.4 mg for weight management. Expert opinion: Liraglutide 3.0 mg provides benefits regarding weight loss and improvements in cardiometabolic risk factors. Promising areas of future research in the field of obesity include dual receptor agonists and the combination of glucagon-like peptide-1 receptor agonists with other molecules.

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Section: Use Of Other Glp-1 Ra Therapy In Obesitymentioning

confidence: 99%

“…STEP 3 explored the efficacy of semaglutide 2.4 mg versus placebo, both combined with IBT [91]. STEP 4 compared continued treatment with semaglutide 2.4 mg versus switch to placebo [92]. Only STEP 2 enrolled patients with T2D [93].…”

Section: Use Of Other Glp-1 Ra Therapy In Obesitymentioning

confidence: 99%

Patient initiation and maintenance of GLP-1 RAs for treatment of obesity

Patel

Smith

2021

Expert Review of Clinical Pharmacology

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“…In der doppelt verblindeten Studie STEP‑1 wurde nun festgestellt, dass bei Adipositas mit dem GLP-1-RA Semaglutid in einer Dosis von 2,4 mg s.c. 1‑mal wöchentlich zusammen mit einer Lebensstilintervention nach etwas mehr als 1 Jahr eine Gewichtsreduktion von 14,9 % (BMI [Body-Mass-Index]: −5,5 kg/m 2 ) erzielt wurde, während allein mit der Lebensstilintervention 2,4 % (BMI: −0,9 kg/m 2 ) erreicht wurden [ 7 ]. Dies bestätigte sich im Prinzip auch in der STEP 3-Studie mit einem sehr viel intensiveren Diät- und Sportprogramm (Semaglutid: −12,4 %, vs. Plazebo: −5,4 %); ein Effekt, der weit über dem anderer zur Gewichtsreduktion eingesetzter Pharmakotherapien hinausgeht und auch mit einer Reduktion des metabolisch ungünstigen viszeralen Fettgewebes und einer Senkung des CRP-Werts (CRP: C‑reaktives Protein) verbunden war ([ 8 ], Abb. 1 ).…”

Section: Adipositas Und Ernährungunclassified

Diabetes Update 2021

Scherbaum

2021

Diabetologe

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“…At week 68, 86-89% of patients without T2D achieved ≥5% body weight loss (STEP 1, 3 and 4), with 69% of patients with T2D achieving this threshold (STEP 2). Across all studies, semaglutide 2.4 mg also demonstrated benefits beyond weight loss on cardiometabolic parameters and patient-reported outcomes (81)(82)(83)(84).…”

Section: Semaglutide In Obesitymentioning

confidence: 89%

Clinical Perspectives on the Use of Subcutaneous and Oral Formulations of Semaglutide

Gallwitz

Giorgino

2021

Front. Endocrinol.

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Early and effective glycemic control can prevent or delay the complications associated with type 2 diabetes (T2D). The benefits of glucagon-like peptide-1 receptor agonists (GLP-1RAs) are becoming increasingly recognized and they now feature prominently in international T2D treatment recommendations and guidelines across the disease continuum. However, despite providing effective glycemic control, weight loss, and a low risk of hypoglycemia, GLP-1RAs are currently underutilized in clinical practice. The long-acting GLP-1RA, semaglutide, is available for once-weekly injection and in a new once-daily oral formulation. Semaglutide is an advantageous choice for the treatment of T2D since it has greater efficacy in reducing glycated hemoglobin and body weight compared with other GLP-1RAs, has demonstrated benefits in reducing major adverse cardiovascular events, and has a favorable profile in special populations (e.g., patients with hepatic impairment or renal impairment). The oral formulation represents a useful option to help improve acceptance and adherence compared with injectable formulations for patients with a preference for oral therapy, and may lead to earlier and broader use of GLP-1RAs in the T2D treatment trajectory. Oral semaglutide should be taken on an empty stomach, which may influence the choice of formulation. As with most GLP-1RAs, initial dose escalation of semaglutide is required for both formulations to mitigate gastrointestinal adverse events. There are also specific dose instructions to follow with oral semaglutide to ensure sufficient gastric absorption. The evidence base surrounding the clinical use of semaglutide is being further expanded with trials investigating effects on diabetic retinopathy, cardiovascular outcomes, and on the common T2D comorbidities of obesity, chronic kidney disease, and non-alcoholic steatohepatitis. These will provide further information about whether the benefits of semaglutide extend to these other indications.

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Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity

Cited by 572 publications

References 37 publications

Patient initiation and maintenance of GLP-1 RAs for treatment of obesity

Patient initiation and maintenance of GLP-1 RAs for treatment of obesity

Diabetes Update 2021

Clinical Perspectives on the Use of Subcutaneous and Oral Formulations of Semaglutide

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