Prior Anti-Obesity Drug Use Curbs Weight Loss on Semaglutide

TOPLINE:

Semaglutide results in more weight loss if patients with overweight or obesity have not previously been treated with anti-obesity medications.

METHODOLOGY:

• Studies of semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), have found heterogeneous weight loss outcomes in patients with overweight or obesity, often for unclear reasons.
• This retrospective study evaluated the effect of the prior use of anti-obesity drugs on the weight loss outcomes of weekly semaglutide injections in 305 US patients (73% women; mean age, 49 years) with overweight or obesity.
• Among the included patients, 231 initiated their weight loss treatment with semaglutide, and 74 patients had previously received another GLP-1 RA or a non-GLP-1 RA.
• The primary endpoint was the difference in the total body weight loss percentage between the groups with and without prior anti-obesity treatment at 12 months after receiving semaglutide.
• The secondary outcome was a comparison of the proportions of patients in each group who achieved ≥ 5%, ≥ 10%, ≥ 15%, and ≥ 20% weight loss.
• At 12 months, patients without previous exposure to an other anti-obesity medication experienced a greater percentage of weight loss with semaglutide (14.3% vs 10.6%; P = .01) than those with previous exposure to an other anti-obesity medication.
• At 12 months, more treatment-naive patients lost more weight on semaglutide than those with previous exposure to another anti-obesity medication: ≥ 15% weight loss (48% vs 21%; P = .02) and ≥ 20% (27% vs 4%; P
• At 9 and 12 months, the treatment naive group lost more weight on semaglutide than people who had previously taken another GLP-1 RA, but researchers found no differences compared with people who had taken a non-GLP-1 RA anti-obesity drug.
• Except for A1c levels, which decreased to a greater extent in patients with no history of previous anti-obesity drug use, all cardiometabolic parameters improved to a comparable extent in both groups.

IN PRACTICE:

"Understanding the impact of the use of previous anti-obesity medications in patients requiring a medication in their weight loss journey would not only assist physicians when deciding on the tool that would provide the best outcomes but also enhance patients' expectations in their weight loss journey, fostering more realistic outcomes," the authors noted.

SOURCE:

This study was led by Wissam Ghusn, PhD, and Sima Fansa, MD, Department of Medicine, Mayo Clinic, Rochester, Minnesota, and published online in Diabetes, Obesity and Metabolism.

LIMITATIONS:

This study included mostly White women, which could limit the generalizability of its findings to other genders or racial groups. Additionally, many patients came from tertiary referral centers, which may have led to selection bias. Furthermore, the start and end dates of anti-obesity drugs were tracked using physician notes and patient messages rather than referring to prescription dates, which may have caused reporting bias.

DISCLOSURES:

The corresponding author declared being supported by the National Institutes of Health and holding equity, serving as a consultant, and having contracts with several biotechnology and pharmaceutical companies.