Tzoulis Ploutarchos, Batavanis Michael, Baldeweg Stephanie
Department of Metabolism and Experimental Therapeutics, University College London, London, GBR.
School of Clinical Medicine, University of Cambridge, Cambridge, GBR.
Cureus. 2024 May 2;16(5):e59558. doi: 10.7759/cureus.59558. eCollection 2024 May.
Introduction Recent randomized controlled trials (RCTs) have shown the great efficacy of semaglutide in achieving significant weight loss in overweight and obese adults. However, real-world data about its effectiveness are still limited. This study evaluated the effectiveness and adverse events of semaglutide for weight management in a real-life setting, excluding patients with diabetes mellitus (DM). Methods This is a retrospective chart review of 40 overweight or obese individuals with a median age of 47 years, weight of 111.7 kg, and body mass index (BMI) of 39.7 kg/m who were prescribed semaglutide for weight management. Results After three months of semaglutide administration, the median weight reduction was 7.4 kg (6.6% of the baseline weight), with 28 (70%) and eight patients (20%) achieving greater than 5% (5.6 kg) and 10% (11.2 kg) weight loss, respectively. Among 25 patients with six-month data, 22 (88%), 17 (68%), and eight (32%) patients exceeded 5% (5.6 kg), 10% (11.2 kg), and 15% (16.8 kg) weight loss, respectively. The maintenance semaglutide dose was 1 mg in 16 cases and 2 mg in nine cases, leading to a similar weight loss of 13.6% (14.9 kg) and 12.8% (14 kg), respectively. Relatively low response rates were observed in males, with seven responders out of 12 (58.4%) compared to 24 out of 28 (85.8%) in females (P value = 0.057), and in five out of nine (55.6%) among those with a history of psychiatric disease. The rate of adverse events was 26 out of 40 patients (65%), mostly mild to moderate and of short duration, leading to discontinuation in only a single case (2.5%). Conclusion This retrospective study demonstrated the significant effectiveness of semaglutide for weight loss, even at lower than approved maintenance doses, combined with a good safety profile. Therefore, semaglutide may dramatically change the landscape of obesity treatment.
引言 近期的随机对照试验（RCT）表明，司美格鲁肽在使超重和肥胖成年人显著减重方面具有显著疗效。然而，关于其有效性的真实世界数据仍然有限。本研究评估了司美格鲁肽在现实生活环境中用于体重管理的有效性和不良事件，排除了糖尿病（DM）患者。方法 这是一项对40名超重或肥胖个体的回顾性病历审查，这些个体的中位年龄为47岁，体重为111.7千克，体重指数（BMI）为39.7千克/米²，他们被开具司美格鲁肽用于体重管理。结果 在使用司美格鲁肽三个月后，中位体重减轻了7.4千克（占基线体重的6.6%），分别有28名（70%）和8名患者（20%）体重减轻超过5%（5.6千克）和10%（11.2千克）。在有六个月数据的25名患者中，分别有22名（88%）、17名（68%）和8名（32%）患者体重减轻超过5%（5.6千克）、10%（11.2千克）和15%（16.8千克）。维持使用司美格鲁肽剂量为1毫克的有16例，2毫克的有9例，分别导致相似的体重减轻，即13.6%（14.9千克）和12.8%（14千克）。在男性中观察到相对较低的反应率，12名中有7名有反应（58.4%），而女性中28名中有24名有反应（85.8%）（P值 = 0.057），在有精神疾病史的患者中9名中有5名有反应（55.6%）。不良事件发生率为40名患者中有26名（65%），大多为轻度至中度且持续时间短，仅1例（2.5%）导致停药。结论 这项回顾性研究表明，司美格鲁肽即使在低于批准的维持剂量时，在减重方面也具有显著有效性，且安全性良好。因此，司美格鲁肽可能会极大地改变肥胖治疗的格局。
