Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Jacksonville, Florida, USA.
Diabetes Obes Metab. 2024 Jun;26(6):2167-2175. doi: 10.1111/dom.15523. Epub 2024 Mar 12.
To compare weight loss outcomes between patients starting semaglutide who had previously been on another anti-obesity medication (AOM) compared to those who were AOM-naïve.
We performed a retrospective study in patients with overweight or obesity taking semaglutide for weight loss for a duration of 3 to 12 months. Our primary endpoint was assessment of percentage of total body weight loss (TBWL) in patients who started semaglutide as their first AOM (AOM-naïve) compared to those who started semaglutide and had previously taken another AOM (non-AOM-naïve). The secondary outcome was a comparison of the proportions of patients achieving ≥5%, ≥10%, ≥15% and ≥20% TBWL between the groups. Our endpoints were analysed using independent t-tests and ANOVA/ANCOVA for continuous variables and Pearson's test for categorical variables.
This study included 305 patients. Outcomes of semaglutide treatment were superior in AOM-naïve patients (n = 231) compared to non-AOM-naïve patients (n = 74) at 3 (6.3% vs. 3.8%), 6 (10.6% vs. 6.7%), 9 (14.0% vs. 9.1%) and 12 months (14.3% vs. 10.6%; p < 0.0001 at 3, 6 and 9 months, and p = 0.01 at 12 months). A greater proportion of patients in the AOM-naïve group achieved a TBWL ≥ 15% (48% vs 21%; p = 0.02) and ≥20% (27% vs 4% p < 0.01) at 12 months.
The use of semaglutide in patients with previous intake of other AOMs was associated with inferior weight loss outcomes in comparison to patients who were AOM-naïve.
比较起始使用司美格鲁肽且之前使用过其他减肥药(AOM)与起始使用司美格鲁肽且未曾使用过其他减肥药(AOM 初治)的患者之间的减重效果。
我们对使用司美格鲁肽进行减重治疗且时长为 3 至 12 个月的超重或肥胖患者进行了回顾性研究。我们的主要终点是比较起始使用司美格鲁肽且之前使用过其他 AOM(AOM 经治)与起始使用司美格鲁肽且未曾使用过其他 AOM(AOM 初治)的患者的体重总降幅百分比(TBWL)。次要终点是比较两组患者达到 ≥5%、≥10%、≥15%和≥20%TBWL 的比例。我们采用独立 t 检验和连续变量的 ANOVA/ANCOVA 以及分类变量的 Pearson 检验对终点进行分析。
这项研究共纳入 305 例患者。在 3、6、9 和 12 个月时,AOM 初治患者(n=231)的司美格鲁肽治疗结局优于 AOM 经治患者(n=74)(6.3% vs. 3.8%、10.6% vs. 6.7%、14.0% vs. 9.1%、14.3% vs. 10.6%;p<0.0001,在 3、6 和 9 个月时,p=0.01,在 12 个月时)。在 12 个月时,AOM 初治组中达到 TBWL≥15%(48% vs. 21%;p=0.02)和≥20%(27% vs. 4%;p<0.01)的患者比例更高。
与 AOM 初治患者相比,起始使用司美格鲁肽且之前使用过其他 AOM 的患者的减重效果较差。