利拉鲁肽 3.0mg 治疗对减重手术后体重反弹患者体重减轻的疗效。

Efficacy of liraglutide 3.0 mg treatment on weight loss in patients with weight regain after bariatric surgery.

机构信息

Division of Endocrinology and Diabetology, Sant'Anna Hospital-ASST Lariana, Como, Italy.

Division of Geriatrics, Sant'Anna Hospital-ASST Lariana, Como, Italy.

出版信息

Eat Weight Disord. 2022 Oct;27(7):2775-2781. doi: 10.1007/s40519-022-01403-9. Epub 2022 Jun 28.

DOI:10.1007/s40519-022-01403-9

PMID:35763245

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9556416/

Abstract

PURPOSE

Bariatric surgery, as Roux-en-Y gastric bypass (RYGB), laparoscopic gastric banding (LGB), and laparoscopic sleeve gastrectomy (LSG), is considered the gold standard treatment to achieve long-term weight loss in severe obesity. In patients who fail to maintain the achieved weight, pharmacological treatment may be required. Here, we reported our real-life experience on the efficacy of liraglutide therapy in 62 patients who regained weight after bariatric surgery.

METHODS

We retrospectively evaluated 62 (60 F-2 M; mean age: 43.6 ± 9.9 years) patients received liraglutide for weight loss after bariatric surgery (17 RYGB, 22 LGB, and 23 LSG). Body mass index (BMI) before and after surgery was, respectively, of 45.4 ± 5.5 kg/m and 29.5 ± 4.9 kg/m. Patients were followed up from 2016 until 2021. Liraglutide was administered after weight regain once-daily subcutaneously at starting dose of 0.6 mg and with weekly increases up to 3.0 mg. Treatments were administered when a weight regain of 10-15% occurred after reaching a minimum weight loss from bariatric surgery or if weight loss after bariatric surgery was unsatisfactory.

RESULTS

After a mean of 70.7 ± 43.7 months from any bariatric surgery, all patients started liraglutide therapy. At this time, mean BMI was 34.2 ± 4.8 kg/m (mean increased BMI: 4.7 ± 2.8 kg/m). After a mean of 10.5 ± 4.4 months from the beginning of liraglutide, 9 patients achieved normal weight (BMI 24.1 ± 0.9 kg/m), and 28 were overweight (BMI 26.9 ± 1.6 kg/m). Twenty patients achieved grade I (BMI 32.1 ± 1.5 kg/m), 5 grade II (BMI 37.3 ± 2.0 kg/m) obesity, and none had grade III obesity (mean BMI change: - 5.1 ± 2.5 kg/m). The treatment was well tolerated, and no serious adverse events were recorded.

CONCLUSION

These data confirm the efficacy and safety of liraglutide in patients who experienced weight regain after bariatric surgery. Considering the long-term follow-up, patients should be followed up regularly and the pharmacological treatment should be adapted to the weight fluctuations observed during the clinical history.

LEVEL OF EVIDENCE

V. Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

摘要

目的

减重手术，如 Roux-en-Y 胃旁路术（RYGB）、腹腔镜胃束带术（LGB）和腹腔镜袖状胃切除术（LSG），被认为是实现重度肥胖长期减重的金标准治疗方法。对于未能维持已达到的体重的患者，可能需要药物治疗。在这里，我们报告了我们在 62 例减重手术后体重反弹的患者中使用利拉鲁肽治疗的真实疗效。

方法

我们回顾性评估了 62 例（60 例女性-2 例男性；平均年龄：43.6±9.9 岁）接受利拉鲁肽治疗以减轻体重的患者，这些患者在减重手术后体重反弹（17 例 RYGB、22 例 LGB 和 23 例 LSG）。手术前后的体重指数（BMI）分别为 45.4±5.5kg/m 和 29.5±4.9kg/m。患者的随访时间从 2016 年至 2021 年。一旦发生体重反弹（减重手术后达到最低体重减轻后反弹 10-15%，或减重手术后体重减轻不理想），就在开始接受利拉鲁肽治疗，每周皮下注射一次，起始剂量为 0.6mg，并每周增加一次，最高可达 3.0mg。

结果

在任何减重手术后平均 70.7±43.7 个月后，所有患者开始接受利拉鲁肽治疗。此时，平均 BMI 为 34.2±4.8kg/m（平均增加 BMI：4.7±2.8kg/m）。在开始利拉鲁肽治疗后平均 10.5±4.4 个月后，9 例患者达到正常体重（BMI 24.1±0.9kg/m），28 例超重（BMI 26.9±1.6kg/m）。20 例患者达到 I 级（BMI 32.1±1.5kg/m）肥胖，5 例达到 II 级（BMI 37.3±2.0kg/m）肥胖，无一例达到 III 级肥胖（平均 BMI 变化：-5.1±2.5kg/m）。治疗耐受性良好，未记录到严重不良事件。