Researchers from the Mayo Clinic, Rochester, MN and the Mayo Clinic, Jacksonville, FL, have reported findings from a cohort study that suggest semaglutide is clinically effective for weight loss at three and six months for people with overweight or obesity. Interestingly, although their study lacked the stringent and closely controlled nature of randomised clinical trials (RCTs), they found similar weight loss results within the same time period as in RCTs.
The researchers noted that no retrospective cohort study has assessed the effectiveness of semaglutide at doses used in RCTs to treat obesity (ie, 1.7 and 2.4 mg). Therefore, they designed a study to look at weight loss outcomes associated with semaglutide treatment at doses used in RCTs for patients with overweight or obesity.
The study was conducted at a referral centre for weight management and retrospectively collected data on the use of semaglutide for adults with overweight or obesity between January 2021 and March 2022, with a follow-up of up to six months. A total of 408 patients with a body mass index (BMI) of 27 or more were prescribed weekly semaglutide 1.7-mg or 2.4-mg subcutaneous injections for three months or more. Patients with a history of bariatric procedures, taking other antiobesity medications, and with an active malignant neoplasm were excluded.
The primary end point was the percentage of weight loss. Secondary end points were the proportion of patients achieving weight loss of 5% or more, 10% or more, 15% or more, and 20% or more after three and six months and the percentage of weight loss for patients with or without type 2 diabetes after three and six months.
The study included 175 patients (132 women [75.4%]; mean [SD] age, 49.3 [12.5] years; mean [SD] BMI, 41.3 [9.1]). The mean (SD) weight loss after three months was 6.7 (4.4) kg, equivalent to a mean (SD) weight loss of 5.9% (3.7%) (p<0.001), and the mean (SD) weight loss after six months was 12.3 (6.6) kg, equivalent to a mean (SD) weight loss of 10.9% (5.8%) (p<0.001 from baseline).
Of the 102 patients who were followed up at six months, 89 (87.3%) achieved weight loss of 5% or more, 56 (54.9%) achieved weight loss of 10% or more, 24 (23.5%) achieved weight loss of 15% or more, and eight (7.8%) achieved weight loss of 20% or more. Patients with type 2 diabetes had a lower mean (SD) percentage weight loss at three and six months compared with those without type 2 diabetes: 3.9% (3.1%) vs 6.3% (3.7%) at three months (p=0.001) and 7.2% (6.3%) vs 11.8% (5.3%) at six months (p=0.005).
Seventy-seven patients (44.0%) received the highest current doses of subcutaneous semaglutide (1.7 and 2.4mg), while 98 (56.0%) received lower doses (0.25, 0.5, and 1mg).
At three months, patients who received the highest doses achieved a mean (SD) weight loss of 6.9% (3.9%) (95% CI, −7.8% to −6.0% [n=77]) compared with a mean (SD) weight loss of 5.1% (3.4%) (95% CI −5.8% to −4.4% [n = 98]) for patients receiving lower doses (p=0.002). At six months, patients receiving the highest doses achieved a mean (SD) weight loss of 12.1% (5.9%) (95% CI, −13.6% to −10.6% [n = 60]) vs a mean (SD) weight loss of 9.2% (5.2%) (95% CI, −10.9% to −7.6% [n = 42]) for patients receiving lower doses (p=0.01).
“To our knowledge, this study is the first retrospective study to evaluate weight loss outcomes associated with treatment with subcutaneous semaglutide, including the highest doses approved for weight loss (>1.0 mg) for patients with overweight or obesity, with or without type 2 diabetes,” they stated. “In our cohort, patients lost approximately 6.7 kg at 3 months and 12.3 kg at six months, equivalent to 5.9% of weight lost at three months and 10.9% of weight lost at six months. Hence, this study may be a stepping stone to demonstrating the effectiveness of semaglutide for patients aiming to lose weight. These results may support the applicability of semaglutide in a less controlled environment, as previously proven in RCTs.”
They concluded that further studies with greater sample sizes and longer periods of follow-up are needed to support the effectiveness of semaglutide.
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