Weight loss response to semaglutide in postmenopausal women with and without hormone therapy use

Abstract

Objective To compare weight loss response and changes in cardiometabolic risk markers in postmenopausal women using semaglutide with and without menopause hormone therapy (HT) use. Methods Retrospective cohort study of postmenopausal women treated with semaglutide for overweight or obesity for ≥3 months. Endpoints: total body weight loss percentage (TBWL%) at 3, 6, 9, and 12 months after semaglutide initiation; and percentage of women achieving ≥5% and ≥10% TBWL and changes in cardiometabolic risk markers (glucose, blood pressure, and lipids) at 12 months. Results There were 16 women on HT and 90 on no-HT; mean age 56 ± 8 vs 59 ± 8 yr, P = 0.2 and mean BMI 36 ± 5 vs 39 ± 8 kg/m2, P = 0.1; respectively. Among women on no-HT, White race, dyslipidemia, and depression were more prevalent. Women on HT had a higher TBWL% at 3, 6, 9, and 12 months: 7 ± 3% vs 5 ± 4%, P = 0.01; 13 ± 6% vs 9 ± 5%, P = 0.01; 15 ± 6% vs 10 ± 6%, P = 0.02; and 16 ± 6% vs 12 ± 8%, P = 0.04; respectively. After adjusting for potential confounders, this association remained significant across time. At 12 months, a greater percentage of women on HT achieved ≥5% and ≥10% TBWL. Both groups experienced an improvement in cardiometabolic risk markers. Conclusion In postmenopausal women with overweight or obesity treated with semaglutide, HT use was associated with an improved weight loss response. This association was maintained when adjusted for confounders. Larger studies should be conducted to confirm these results.

Letter to the Editor

“…We applaud the clinical intuition of Hurtado et al to investigate the role of hormone therapy (HT) in menopausal obese and overweight women receiving semaglutide therapy in the original study, ''Weight loss response to semaglutide in postmenopausal women with and without hormone therapy use''. 1 This analysis of 106 patients showed a marked advantage for the 16 users of HTwith up to 50% and 33% more weight percentage weight loss as measured quarterly in the first 12 months. They also cite the findings of Papadikis in the OsteoLaus study who demonstrated decreased visceral adipose tissue, body mass index, and android fat mass on serial dual-energy x-ray absorptiometry imaging in current users of HT, but not past users or never users, in the perimenopausal window.…”

“…We applaud the clinical intuition of Hurtado et al to investigate the role of hormone therapy (HT) in menopausal obese and overweight women receiving semaglutide therapy in the original study, ''Weight loss response to semaglutide in postmenopausal women with and without hormone therapy use'' 1 . This analysis of 106 patients showed a marked advantage for the 16 users of HT with up to 50% and 33% more weight percentage weight loss as measured quarterly in the first 12 months.…”