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Weight loss effect of liraglutide in real-life: the experience of a single Italian obesity center

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Abstract

Purpose

Several randomized controlled clinical trials (RCCTs) have shown that the use of Liraglutide (L) in addition to diet and exercise in patients with obesity or overweight (OO), compared to dietary behavioral changes alone, leads to a significantly greater weight loss. This retrospective study aimed at evaluating the effectiveness of L therapy in a real-life setting.

Methods

93 consecutive non-diabetic OO, referring to a single Obesity Center, started L therapy from October 2016 to December 2018: 21/93 OO discontinued the treatment within 90 days for various reasons. 72/93 OO (55 females, 17 males), mean ± SD age 49 ± 12.5 years (18–78) and mean body mass index 39.1 ± 5.8 (28.3–55.3) were included for further analysis. 60/72 OO reached the final dose of 3.0 mg/day.

Results

Mean weight loss was 7.1% in the OO who reached the dose of 3.0 mg; 68.3%, 20.0% and 10.0% of OO lost ≥ 5%, 10% and 15% of body weight, respectively. A linear correlation between early and final weight loss was found. Moreover, we observed a significant reduction of mean systolic and diastolic blood pressure and a significant increase of mean heart rate. The overall incidence of side effects was 18.3% (17/93).

Conclusion

L treatment of OO in a real life setting yielded results comparable to those reported by the major RCCTs. Combining the results of RCCTs with the observations from real life may increase their power and overcome their respective limitations.

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References

  1. Bray GA (1990) Obesity: historical development of scientific and cultural ideas. Int J Obes 14:909–926

    CAS  PubMed  Google Scholar 

  2. Friedman JM (2019) Leptin and the endocrine control of energy balance. Nat Metab 1:754–764. https://doi.org/10.1038/s42255-019-0095-y

    Article  CAS  PubMed  Google Scholar 

  3. Pi-Sunyer FX (2000) Obesity: criteria and classification. Proc Nutr Soc 59:505–509. https://doi.org/10.1017/s0029665100000732

    Article  CAS  PubMed  Google Scholar 

  4. Piaggi P, Vinales KL, Basolo A, Santini F, Krakoff J (2018) Obesity and energy expenditure in the etiology of human obesity: spendthrift and thrifty metabolic phenotypes and energy-sensing mechanisms. J Endocrinol Invest 41:83–89. https://doi.org/10.1007/s40618-017-0732-9

    Article  CAS  PubMed  Google Scholar 

  5. Pineda E, Sanchez-Romero LM, Brown M, Jaccard A, Jewell J, Galea G, Webber L, Breda J (2018) Forecasting future trends in obesity across Europe: the value of improving surveillance. Obes Facts 11:360–371. https://doi.org/10.1159/000492115

    Article  PubMed  PubMed Central  Google Scholar 

  6. Sbraccia P, Crialesi R, Nicolucci A (2020) 2nd Italian obesity barometer report. Obesity Monitor. https://viewer.ipaper.io/sp-servizi-pubblicitari-srl/obesity-barometer-monitor/#/. Accessed 12 May 2020

  7. Ryan DH, Kahan S (2018) Guideline recommendations for obesity management. Med Clin North Am 102:49–63. https://doi.org/10.1016/j.mcna.2017.08.006

    Article  PubMed  Google Scholar 

  8. Santini F, Busetto L, Cresci B, Sbraccia P (2016) SIO management algorithm for patients with overweight or obesity: consensus statement of the Italian Society for Obesity (SIO). Eat Weight Disord 21:305–307. https://doi.org/10.1007/s40519-016-0279-3

    Article  PubMed  PubMed Central  Google Scholar 

  9. Agenzia italiana del farmaco (2020) Saxenda allegato 1 riassunto delle caratteristiche del prodotto.https://farmaci.agenziafarmaco.gov.it/aifa/servlet/PdfDownloadServlet?pdfFileName=footer_000085_044018_RCP.pdf&retry=0&sys=m0b1l3 Accessed 12 May 2020.

  10. Sbraccia P, Muratori F, Santini F, Busetto L, Caretto A, Caregaro Negrin L, Paolini B (2017) Standard italiani per la cura dell’obesità SIO ADI 2016–2017. https://www.sio-obesita.org/wp-content/uploads/2017/09/STANDARD-OBESITA-SIO-ADI.pdf. Accessed 12 May 2020.

  11. Agersø H, Jensen LB, Elbrønd B, Rolan P, Zdravkovic M (2002) The pharmacokinetics, pharmacodynamics, safety and tolerability of NN2211, a new long-acting GLP-1 derivative, in healthy men. Diabetologia 45:195–202. https://doi.org/10.1007/s00125-001-0719-z

    Article  PubMed  Google Scholar 

  12. Larsen PJ, Fledelius C, Knudsen LB, Tang-Christensen M (2001) Systemic administration of the long-acting GLP-1 derivative NN2211 induces lasting and reversible weight loss in both normal and obese rats. Diabetes 50:2530–2539. https://doi.org/10.2337/diabetes.50.11.2530

    Article  CAS  PubMed  Google Scholar 

  13. Secher A, Jelsing J, Baquero AF, Hecksher-Sørensen J, Cowley MA, Dalbøge LS, Hansen G, Grove KL, Pyke C, Raun K, Schäffer L, Tang-Christensen M, Verma S, Witgen BM, Vrang N, Bjerre Knudsen L (2014) The arcuate nucleus mediates GLP-1 receptor agonist liraglutide-dependent weight loss. J Clin Invest 124:4473–4488. https://doi.org/10.1172/JCI75276

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Astrup A, Rössner S, Van Gaal L, Rissanen A, Niskanen L, Al Hakim M, Madsen J, Rasmussen MF, Lean ME, NN8022-1807 Study Group (2009) Effects of liraglutide in the treatment of obesity: a randomised, double-blind, placebo-controlled study. Lancet 374:1606–1616. https://doi.org/10.1016/S0140-6736(09)61375-1

    Article  CAS  PubMed  Google Scholar 

  15. Astrup A, Carraro R, Finer N, Harper A, Kunesova M, Lean ME, Niskanen L, Rasmussen MF, Rissanen A, Rössner S, Savolainen MJ, Van Gaal L, NN8022-1807 Investigators (2012) Safety, tolerability and sustained weight loss over 2 years with the once-daily human GLP-1 analog, liraglutide. Int J Obes (Lond) 36:843–854. https://doi.org/10.1038/ijo.2011.158

    Article  CAS  Google Scholar 

  16. Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, Lau DC, le Roux CW, Violante-Ortiz R, Jensen CB, Wilding JP, SCALE Obesity, and Prediabetes NN8022-1839 Study Group (2015) A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med. 373:11–22. https://doi.org/10.1056/NEJMoa1411892

    Article  CAS  PubMed  Google Scholar 

  17. Davies MJ, Bergenstal R, Bode B, Kushner RF, Lewin A, Skjøth TV, Andreasen AH, Jensen CB, DeFronzo RA, NN8022-1922 Study Group (2015) Efficacy of liraglutide for weight loss among patients with type 2 diabetes: the SCALE diabetes randomized clinical trial. JAMA 314:687–699. https://doi.org/10.1001/jama.2015.9676

    Article  CAS  PubMed  Google Scholar 

  18. Blackman A, Foster GD, Zammit G, Rosenberg R, Aronne L, Wadden T, Claudius B, Jensen CB, Mignot E (2016) Effect of liraglutide 3.0 mg in individuals with obesity and moderate or severe obstructive sleep apnea: the SCALE sleep apnea randomized clinical trial. Int J Obes 40:1310–1319. https://doi.org/10.1038/ijo.2016.52

    Article  CAS  Google Scholar 

  19. Wadden TA, Hollander P, Klein S, Niswender K, Woo V, Hale PM, Aronne L, NN8022-1923 Investigators (2013) Weight maintenance and additional weight loss with liraglutide after low-calorie-diet-induced weight loss: the SCALE maintenance randomized study. Int J Obes 37:1441–1451. https://doi.org/10.1038/ijo.2013.120

    Article  CAS  Google Scholar 

  20. Wilding JPH, Overgaard RV, Jacobsen LV, Jensen CB, le Roux CW (2016) Exposure-response analyses of liraglutide 3.0 mg for weight management. Diabetes Obes Metab 18:491–499. https://doi.org/10.1111/dom.12639

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Davies MJ, Aronne LJ, Caterson ID, Thomsen AB, Jacobsen PB, Marso SP, the Satiety, and Clinical Adiposity–Liraglutide Evidence in individuals with, and without diabetes (SCALE) study groups (2018) Liraglutide and cardiovascular outcomes in adults with overweight or obesity: a post hoc analysis from SCALE randomized controlled trials. Diabetes Obes Metab 20:734–739. https://doi.org/10.1111/dom.13125

    Article  CAS  PubMed  Google Scholar 

  22. Wadden TA, Tronieri JS, Sugimoto D, Lund MT, Auerbach P, Jensen C, Rubino D (2020) Liraglutide 3.0 mg and intensive behavioral therapy (IBT) for obesity in primary care: the SCALE IBT randomized controlled trial. Obesity 28:529–536. https://doi.org/10.1002/oby.22726

    Article  CAS  PubMed  Google Scholar 

  23. Garvey WT, Birkenfeld AL, Dicker D, Mingrone G, Pedersen SD, Satylganova A, Skovgaard D, Sugimoto D, Jensen C, Mosenzon O (2020) Efficacy and safety of liraglutide 3.0 mg in individuals with overweight or obesity and type 2 diabetes treated with basal insulin: the SCALE insulin randomized controlled trial. Diabetes Care. https://doi.org/10.2337/dc19-1745

    Article  PubMed  PubMed Central  Google Scholar 

  24. Harari S (2018) Randomised controlled trials and real-life studies: two answers for one question. Eur Respir Rev. https://doi.org/10.1183/16000617.0080-2018

    Article  PubMed  Google Scholar 

  25. Saturni S, Bellini F, Braido F, Paggiaro P, Sanduzzi A, Scichilone N, Santus PA, Morandi l, Papi A (2014) Randomized controlled trials and real life studies. Approaches and methodologies: a clinical point of view. Pulm Pharmacol Ther 27:129–138. https://doi.org/10.1016/j.pupt.2014.01.005

    Article  CAS  PubMed  Google Scholar 

  26. Wharton S, Liu A, Pakseresht A, Nørtoft E, Haase CL, Mancini J, Power GS, Vanderlelie S, Christensen RAG (2019) Real-world clinical effectiveness of liraglutide 3.0 mg for weight management in Canada. Obesity 27:917–924. https://doi.org/10.1002/oby.22462

    Article  CAS  Google Scholar 

  27. Maccora C, Ciuoli C, Goracci A, Benenati N, Formichi C, Pilli T, Verdino V, Mnutr ON, Bufano A, Tirone A, Voglino C, Fagiolini A, Castagna MG (2020) One month weight loss predicts the efficacy of liraglutide in obese patients: data from a single center. Endocr Pract 26:235–240. https://doi.org/10.4158/EP-2019-0169

    Article  PubMed  Google Scholar 

  28. Gorgojo-Martínez JJ, Basagoiti-Carreño B, Sanz-Velasco A, Serrano-Moreno C, Almodóvar-Ruiz F (2019) Effectiveness and tolerability of orlistat and liraglutide in patients with obesity in a real-world setting: the XENSOR study. Int J Clin Pract. https://doi.org/10.1111/ijcp.13399

    Article  PubMed  Google Scholar 

  29. le Roux C, Aroda V, Hemmingsson J, Cancino AP, Christensen R, Pi-Sunyer X (2017) Comparison of efficacy and safety of liraglutide 3.0 mg in individuals with BMI above and below 35 kg/m2: a post-hoc analysis. Obes Facts 10:531–544. https://doi.org/10.1159/000478099

    Article  PubMed  PubMed Central  Google Scholar 

  30. Rigato M, Avogaro A, Fadini GP (2015) Effects of dose escalating liraglutide from 1.2 to 1.8 mg in clinical practice: a case-control study. J Endocrinol Invest 38:1357–1363. https://doi.org/10.1007/s40618-015-0385-5

    Article  CAS  PubMed  Google Scholar 

  31. Fujioka K, O'Neil PM, Davies M, Greenway F, C W Lau D, Claudius B, Skjøth TV, Bjørn Jensen C, P H Wilding J (2016) Early weight loss with liraglutide 3.0 mg predicts 1-year weight loss and is associated with improvements in clinical marker. Obesity 24:2278–2288. https://doi.org/10.1002/oby.21629

    Article  CAS  PubMed  Google Scholar 

  32. Cohen JB (2017) Hypertension in obesity and the impact of weight loss. Curr Cardiol Rep 19:98. https://doi.org/10.1007/s11886-017-0912-4

    Article  PubMed  PubMed Central  Google Scholar 

  33. Cohen JB, Gadde KM (2019) Weight loss medications in the treatment of obesity and hypertension. Curr Hypertens Rep 21:16. https://doi.org/10.1007/s11906-019-0915-1

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Wadden TA, Walsh O, Berkowitz RI, Chao AM, Alamuddin N, Gruber K, Leonard S, Mugler K, Bakizada Z, Tronieri JS (2019) Intensive behavioral therapy for obesity combined with liraglutide 3.0 mg: a randomized controlled trial. Obesity 27:75–86. https://doi.org/10.1002/oby.22359

    Article  CAS  PubMed  Google Scholar 

  35. Capristo E, Panunzi S, De Gaetano A, Raffaelli M, Guidone C, Iaconelli A, L'Abbate L, Birkenfeld AL, Bellantone R, Borstein SR, Mingrone G (2017) Intensive lifestyle modifications with or without liraglutide 3.0 mg vs sleeve gastrectomy: a three-arm non-randomised, controlled, pilot study. Diabetes Metab 44:235–242. https://doi.org/10.1016/j.diabet.2017.12.007

    Article  PubMed  Google Scholar 

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Aknowledgements

We thank Dr. Paolo Piaggi for his support in statistical analysis. We acknowledge Graphpad version 5 was used to create the artwork.

Funding

This research was partially funded by the Italian Ministry of the University, Project code 2017L8Z2EM: Mechanisms of adipose tissue dysfunction in obesity: a target of future weight loss strategies for the prevention of diabetes and cardiovascular diseases.

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Authors and Affiliations

  1. Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, Pisa, Italy

    F. Ferrari, P. Fierabracci, G. Salvetti, R. Jaccheri, J. Vitti, G. Scartabelli, A. Meola, S. Magno, G. Ceccarini & F. Santini

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  1. F. Ferrari
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  2. P. Fierabracci
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  3. G. Salvetti
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Contributions

FF, PF, GSa, FS contributed to the study design. PF, GSa, GSc, AM, RJ and JV performed outpatient visits and selected patients. Data collection was carried out by FF, PF and SM. FF, GC, FS performed the statistical analysis and drew the figures. FF, PF, GC and FS wrote the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to F. Santini.

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Conflicts of interest

F.F. has received travel funds from the following companies involved with lipodystrophy, obesity and/or diabetes treatments: Novo Nordisk, Aegerion, Amryt Pharmaceuticals.P.F has received travel funds from the following companies involved with obesity and/or diabetes treatments: Novo Nordisk, Bruno Farmaceutici, LJ Pharma. G.S. has received fees for sponsor seminar and travel funds from the following companies involved with obesity and/or diabetes treatments: Novo Nordisk, Penta. R.J. has received travel funds from the following companies involved with obesity and/or diabetes treatments: Novo Nordisk, Bioitalia, Nestlè, Kalibra. J.V. has received travel funds from the following companies involved with obesity and/or diabetes treatments: Novo Nordisk, Kalibra, GlaxoSmithKline. G.S. has received travel funds from the following company involved with obesity and/or diabetes treatments: Novo Nordisk. A.M. has received travel funds from the following company involved with obesity and/or diabetes treatments: Novo Nordisk. S.M. has received travel funds from the following companies involved with lipodystrophy, obesity and/or diabetes treatments: Novo Nordisk, Aegerion, Amryt Pharmaceuticals.G.C. has received fees for consulting, and/or received travel funds from the following companies that are involved with lipodystrophy, obesity and/or diabetes treatments: AstraZeneca, Aegerion, Novonordisk, Amryt Pharmaceuticals and Rhythm Pharmaceuticals. F.S. has worked as a consultant, participated in studies and/or received travel funds from the following companies that are involved with lipodystrophy, obesity and/or diabetes treatments: AstraZeneca, Aegerion, Amryt Pharmaceuticals, Bruno Farmaceutici, Novo Nordisk.

Ethics approval

All procedures performed in this study were in accordance with the ethical standards of the Local Ethical Committee and with the 1964 Helsinki declaration and its later amendments.

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Patients gave a general consent to the use of anonimysed data for research purpose.

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Ferrari, F., Fierabracci, P., Salvetti, G. et al. Weight loss effect of liraglutide in real-life: the experience of a single Italian obesity center. J Endocrinol Invest 43, 1779–1785 (2020). https://doi.org/10.1007/s40618-020-01334-1

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