Reduced Body Weight in an Obese Population

Obese patients benefited from the use of 3.0 mg of the glucagon-like peptide (GLP) 1 receptor agonist liraglutide in addition to diet and exercise to help reduce body weight and improve metabolic control, results of a new study showed.

Patients in a 56-week study assigned to liraglutide in combination with diet and exercise were able to lose about 5.5 kg more body weight than those patients assigned to placebo.

“The treatment effect was similar in patients with prediabetes and those without prediabetes and was similar across baseline BMI categories,” wrote Xavier Pi-Sunyer, MD, of Columbia University, and colleagues from the SCALE Obesity and Prediabetes NN8022-1839 Study Group in The New England Journal of Medicine.

The study included 3,731 patients without type 2 diabetes, but with body mass index (BMI) of 30 or greater, or a BMI of 27 with treated or untreated dyslipidemia or hypertension. The patients were assigned 2:1 to daily liraglutide 3.0 mg (n=2,487) or placebo (n=1,244) in addition to lifestyle modification counseling.

The mean weight of patients at baseline was 106 kg and the mean BMI was 38.3.

At the 56-week follow-up point, patients assigned liraglutide had lost an average of 8.4 kg of body weight compared with 2.8 kg for patients in the placebo group (95% CI, -6.0 to -5.1; P<0.001). A weight reduction of at least 5% of body weight occurred in 63.2% of liraglutide patients compared with 27.1% of patients assigned placebo (P<0.001); 33.1% of patients assigned liraglutide achieved a 10% body weight reduction compared with 10.6% of patients assigned placebo (P<0.001).

The researchers also examined health-related quality of life outcomes using the SF-36 form and the Impact of Weight on Quality of Life-Lite questionnaire. They found that treatment with liraglutide resulted in more favorable individual domain scores using both instruments compared with treatment with placebo.

“The total score and the scores for weight management and treatment burden on the Treatment Related Impact Measure–Weight questionnaire were also higher in the liraglutide group than in the placebo group, although the liraglutide group had a lower score for the experience of side effects,” the researchers wrote.

Mild to moderate nausea and diarrhea were the most commonly reported adverse events among patients assigned to liraglutide. Overall serious events occurred in 6.2% of patients assigned the GLP-1 receptor agonist compared with 5% of patients assigned placebo.

“Liraglutide treatment was associated with reductions in cardiometabolic risk factors, including waist circumference, blood pressure, and inflammatory markers,” the researchers wrote. “Modest improvements in fasting lipid levels were also observed, although the clinical relevance of these improvements is uncertain.”

Reference: Pi-Sunyer X, Astrup A, Fujioka K, et al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med. 2015;373:11-22.