One Month Weight Loss Predicts the Efficacy of Liraglutide in Obese Patients: Data from A Single Center

Maccora, Carla; Ciuoli, Cristina; Goracci, Arianna; Benenati, Nicoletta; Formichi, Caterina; Pilli, Tania; Verdino, Valeria; Mnutr, Ornella Neri; Bufano, Annalisa; Tirone, Andrea; Voglino, Costantino; Fagiolini, Andrea; Castagna, Maria Grazia

doi:10.4158/ep-2019-0169

Cited by 13 publications

(13 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hence, we can only speculate that differences in initial BMI and change in BMI following pharmacotherapy would have driven greater weight loss in those patients with SG. According to available data in non-surgical patients, early treatment response (1-3 months) to the weight loss drug seems to be a good predictor of long-term weight maintenance [31][32][33][34]. Metabolic predictors of weight loss could not have been identified in patients treated with exenatide twice daily subcutaneously [35].…”

Section: Discussionmentioning

confidence: 99%

The Potential of Semaglutide Once-Weekly in Patients Without Type 2 Diabetes with Weight Regain or Insufficient Weight Loss After Bariatric Surgery—a Retrospective Analysis

et al. 2022

View full text Add to dashboard Cite

Purpose About 20–25% of patients experience weight regain (WR) or insufficient weight loss (IWL) after bariatric metabolic surgery (BS). Therefore, we aimed to retrospectively assess the effectiveness of adjunct treatment with the GLP-1 receptor agonist semaglutide in non-diabetic patients with WR or IWL after BS. Materials and Methods Post-bariatric patients without type 2 diabetes (T2D) with WR or IWL (n = 44) were included in the analysis. The primary endpoint was weight loss 3 and 6 months after initiation of adjunct treatment. Secondary endpoints included change in BMI, HbA1c, lipid profile, hs-CRP, and liver enzymes. Results Patients started semaglutide 64.7 ± 47.6 months (mean ± SD) after BS. At initiation of semaglutide, WR after post-bariatric weight nadir was 12.3 ± 14.4% (mean ± SD). Total weight loss during semaglutide treatment was − 6.0 ± 4.3% (mean ± SD, p < 0.001) after 3 months (3.2 months, IQR 3.0–3.5, n = 38) and − 10.3 ± 5.5% (mean ± SD, p < 0.001) after 6 months (5.8 months, IQR 5.8–6.4, n = 20). At 3 months, categorical weight loss was > 5% in 61% of patients, > 10% in 16% of patients, and > 15% in 2% of patients. Triglycerides (OR = 0.99; p < 0.05), ALT (OR = 0.87; p = 0.05), and AST (OR = 0.89; p < 0.05) at baseline were negatively associated with weight loss of at least 5% at 3 months’ follow-up (p < 0.05). Conclusion Treatment options to manage post-bariatric excess weight (regain) are scarce. Our results imply a clear benefit of adjunct treatment with semaglutide in post-bariatric patients. However, these results need to be confirmed in a prospective randomized controlled trial to close the gap between lifestyle intervention and revision surgery in patients with IWL or WR after BS. Graphical abstract

show abstract

Section: Discussionmentioning

confidence: 99%

The Potential of Semaglutide Once-Weekly in Patients Without Type 2 Diabetes with Weight Regain or Insufficient Weight Loss After Bariatric Surgery—a Retrospective Analysis

et al. 2022

View full text Add to dashboard Cite

show abstract

“…For this purpose, we proposed a stratification of bariatric patients in four groups of risk depending on the type of surgery and 1 month %TWL. An intensive follow-up program should be reserved for patients at high risk of weight regain with the aim of promoting a prompt multidisciplinary approach, including nutritional and psychiatric counseling, behavior intervention, and pharmacotherapy to maximize weight loss and minimize the costs of health system [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Follow-up after bariatric surgery: is it time to tailor it? Analysis of early predictive factors of 3-year weight loss predictors of unsuccess in bariatric patients

et al. 2022

Self Cite

View full text Add to dashboard Cite

Bariatric surgery (BS) is the most effective treatment strategy for obesity. Nevertheless, a subset of patients does not reach a successful weight loss or experience long-term weight regain. Conflicting evidence exists regarding predictors of BS outcomes. We aimed to define the early factors linked to 3 year unsuccessful weight loss in order to promote a tailored close follow-up. We enrolled 443 patients who underwent BS from January 2014 to December 2018 with a 3 year follow-up. An unsuccessful BS outcome was defined as a percentage of total weight loss (%TWL) < 20. We compared the characteristics between successful and unsuccessful patients in order to identify predictor factors of unsuccess after surgery. We found that the proportion of patients with unsuccessful weight loss progressively increased from one to three years after BS. In a multiple regression model, only 1 month %TWL and sleeve gastrectomy (SG) were significantly associated with 3 year unsuccessful weight loss. We stratified our cohort in four groups according to the risk of BS unsuccess, in terms of 1 month %TWL and type of surgery (SG vs gastric bypass). Interestingly, groups showed a significant difference in terms of %TWL at each follow-up point. Patients submitted to SG with lower 1 month %TWL must be considered at higher risk of future weight regain; consequently, they require a tailored and closer follow-up. Graphical abstract

show abstract

“…Another study aiming to predict short‐term liraglutide effectiveness evaluated a cohort of 100 patients at baseline and 1, 3, and 6 months after treatment 64 . Patients were stratified by underlying psychiatric disorder (binge eating, with/without psychiatric disorders), and weight loss was similar amongst the three groups.…”

Section: Potential Contributors To Variation In Weight‐loss Responsementioning

confidence: 99%

“…Patients were stratified by underlying psychiatric disorder (binge eating, with/without psychiatric disorders), and weight loss was similar amongst the three groups. Although researchers considered sociodemographic/metabolic factors, food consumption, smoking, and physical activity and their correlations with liraglutide efficacy, weight loss at 1 month was the lone variable predictive of positive response to liraglutide 64 . Similarly, a randomized, placebo‐controlled trial in people with obesity looking at predictors of weight loss success with liraglutide determined that >1‐kg weight loss in the initial 5 weeks (AUROC = 0.96) is likely predictive of >4‐kg weight loss at 16 weeks 65 …”

Section: Potential Contributors To Variation In Weight‐loss Responsementioning

confidence: 99%

“…93 Another study aiming to predict short-term liraglutide effectiveness evaluated a cohort of 100 patients at baseline and 1, 3, and 6 months after treatment. 64 Patients were stratified by underlying psychiatric disorder (binge eating, with/without psychiatric disorders), and weight loss was similar amongst the three groups. Although researchers considered sociodemographic/metabolic factors, food consumption, smoking, and physical activity and their correlations with liraglutide efficacy, weight loss at 1 month was the lone variable predictive of positive response to liraglutide.…”

Section: Initial Weight Lossmentioning

confidence: 99%

See 1 more Smart Citation

Potential contributors to variation in weight‐loss response to liraglutide

Webster

Mittal

Dhurandhar³

et al. 2023

Obesity Reviews

View full text Add to dashboard Cite

Obesity treatment requires a chronic state of negative energy balance. Obesity medications can help with this, increasing long-term dietary compliance by promoting satiety or reducing hunger. However, efficacy and safety of obesity medications vary for individuals. Early identification of non-responders to obesity medications may limit drug exposure while optimizing benefits for responders. This review summarizes factors that impact weight-loss response to liraglutide. Factors linked to greater weight loss on liraglutide include being female, not having diabetes, having relatively high baseline weight, and losing at least 4% of initial weight after 16 weeks of treatment. Other covariates that may predict treatment response but require further confirmation include central effects, nausea, gastric emptying of solids, and genotype. Baseline body mass index, race, and age seem less relevant for predicting weight-loss response to liraglutide.Lesser known and harder-to-measure factors such as cerebral blood flow, food cue reactivity, gut hormone levels, and dietary adherence possibly impact variability of response to liraglutide. This information should assist healthcare providers with establishing realistic weight-loss probability for individual patients. Future research should improve the ability to identify responders to liraglutide. Importantly, this review may provide a framework to identify responders to other obesity medications.

show abstract

One Month Weight Loss Predicts the Efficacy of Liraglutide in Obese Patients: Data from A Single Center

Cited by 13 publications

References 13 publications

The Potential of Semaglutide Once-Weekly in Patients Without Type 2 Diabetes with Weight Regain or Insufficient Weight Loss After Bariatric Surgery—a Retrospective Analysis

The Potential of Semaglutide Once-Weekly in Patients Without Type 2 Diabetes with Weight Regain or Insufficient Weight Loss After Bariatric Surgery—a Retrospective Analysis

Follow-up after bariatric surgery: is it time to tailor it? Analysis of early predictive factors of 3-year weight loss predictors of unsuccess in bariatric patients

Potential contributors to variation in weight‐loss response to liraglutide

Contact Info

Product

Resources

About