Real-World Semaglutide Weight Loss Below Trial Levels

TOPLINE:

• Real-world data from patients prescribed semaglutide suggest strong but attenuated weight loss after 52 weeks compared with clinical trial findings.

• Interactions with certain medications and biological factors can be associated with greater or lesser weight loss.

METHODOLOGY:

TAKEAWAY:

• In the overall population of people who took semaglutide, patients lost an average 4.44% of their initial body weight. Male patients loss less than female patients (3.66% vs 5.08%).

• The proportions losing ≥5% and ≥10% of their body weight were 41.9% and 18.1%, respectively.

• At 52 weeks from the start of semaglutide treatment, patients on average lost 4.43% of their initial body weight (3.83% male patients, 4.86% female patients).

• Patients with diabetes lost 3.86% of initial weight at 52 weeks, as compared with 7.44% of patients who did not have diabetes.

• Factors significantly associated with losing ≥10% weight 52 weeks after semaglutide exposure were adrenal gland disorders (adjusted odds ratio [aOR], 25.45), linaclotide use (aOR, 14.95), prediabetes (aOR, 2.32), and codeine use (aOR, 2.97).

• Factors associated with a decreased likelihood of achieving ≥10% weight loss included having diabetes (aOR, 0.44) and receiving a dulaglutide prescription (aOR, 0.26).

IN PRACTICE:

• “This highlights the challenges of realistically achieving significant weight loss in the real world compared with the clinical trial setting.”

• “These findings suggest patient-level factors worth considering that may influence weight-loss performance with semaglutide and directions for further research on how to personalize this method of weight-loss therapy.”

SOURCE:

• Study was conducted by William Powell, of the Department of Biomedical and Health Informatics, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri, and colleagues.

• The study was published on August 18 in Obesity

LIMITATIONS:

• Adherence was not assessed.

• The researchers had no information about patients’ lifestyle practices.

• The model had low sensitivity, and there was a potential for false negative findings.

• There were no data for doses >2 mg/wk.

DISCLOSURES:

Miriam E. Tucker is a freelance journalist based in the Washington, DC, area. She is a regular contributor to Medscape. Other work of hers has appeared in the Washington Post, NPR’s Shots blog, and Diabetes Forecast magazine. She can be found on X @MiriamETucker.

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Cite this: Real-World Semaglutide Weight Loss Below Trial Levels – Medscape – Sep 19, 2023.