Medhati Pourya, Shin Thomas H, Wasden Katherine, Mathur Vasundhara, Apovian Caroline, Nimeri Abdelrahman, Sheu Eric G, Tavakkoli Ali
Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH.
Laboratory for Surgical and Metabolic Research, Brigham and Women's Hospital, Boston, MA.
Ann Surg. 2025 May 6. doi: 10.1097/SLA.0000000000006748.
To investigate weight loss outcomes of semaglutide in a real-world setting, specifically in patients who have undergone metabolic/bariatric surgery (MBS).
Despite excellent weight loss for semaglutide in clinical trials, actual results may be limited due to factors such as costs, drug availability, insurance coverage, and adverse events.
A retrospective series of patients with obesity prescribed semaglutide at a large multidisciplinary weight management center in a tertiary academic institution. Primary endpoints were compliance and percentage total weight loss (%TWL) within 1 year of semaglutide prescription, with further evaluation of weight loss in those with previous history of MBS.
The average [SD] %TWL at 1 year among all patients prescribed semaglutide was 8.8% [10.5]. Of 1,072 patients prescribed semaglutide, 199/1072 (18.6%) did not start semaglutide mainly due to access issues, and 268/1072 (25%) discontinued it within 1 year primarily due to patient factors and side effects. Among patients who completed 1 year of treatment, %TWL was 10.9% [9.8]. In those with history of MBS, %TWL was higher in patients who underwent Roux-en-Y Gastric Bypass (RYGB), but not sleeve gastrectomy, compared to no MBS history (13.6% [10.3] vs. 10.1% [9.6]; P=0.022). Furthermore, %TWL with semaglutide was less in those with BMI>40, than those with BMI<40.
1-year semaglutide compliance is low at 56.4%. 1-year TWL for all patients prescribed semaglutide was 8.8%, and 10.9% for those who took semaglutide for 1 complete year. Patients who underwent RYGB tended to lose more weight with semaglutide than naïve MBS patients.
在真实世界环境中，特别是在接受代谢/减重手术（MBS）的患者中，研究司美格鲁肽的减重效果。
尽管司美格鲁肽在临床试验中减重效果良好，但由于成本、药物可及性、保险覆盖范围和不良事件等因素，实际结果可能有限。
在一所三级学术机构的大型多学科体重管理中心，对一系列接受司美格鲁肽治疗的肥胖患者进行回顾性研究。主要终点是司美格鲁肽处方后1年内的依从性和总体重减轻百分比（%TWL），并对既往有MBS病史的患者的体重减轻情况进行进一步评估。
所有接受司美格鲁肽治疗的患者在1年时的平均[标准差]%TWL为8.8%[10.5]。在1072例接受司美格鲁肽治疗的患者中，199/1072（18.6%）主要由于获取问题未开始使用司美格鲁肽，268/1072（25%）在1年内停药，主要原因是患者因素和副作用。在完成1年治疗的患者中，%TWL为10.9%[9.8]。与无MBS病史的患者相比，有MBS病史的患者中，接受Roux-en-Y胃旁路术（RYGB）而非袖状胃切除术的患者%TWL更高（13.6%[10.3]对10.1%[9.6]；P=0.022）。此外，BMI>40的患者使用司美格鲁肽后的%TWL低于BMI<40的患者。
司美格鲁肽1年的依从性较低，为56.4%。所有接受司美格鲁肽治疗的患者1年的TWL为8.8%，服用司美格鲁肽满1年的患者为10.9%。接受RYGB手术的患者使用司美格鲁肽后往往比未接受MBS手术的患者减重更多。
Zotero 插件