Al-Najim Werd, Dehestani Babak, Al-Humadi Ahmed W, Bodicoat Danielle H, Papamargaritis Dimitris, Lean Michael, McGowan Barbara, Webb David R, Wilding John Ph, Davies Melanie J, le Roux Carel W
Clinical Research Centre, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin 4, Ireland.
Metabolites. 2025 Jun 13;15(6):398. doi: 10.3390/metabo15060398.
The STRIVE study was a multicentre, open-label, real-world clinical trial evaluating the effectiveness of a targeted prescribing pathway for liraglutide 3.0 mg as an adjunct to standard care versus standard care alone in people with obesity attending Specialist Weight Management Services (SWMS) in the UK and Ireland. This post hoc analysis focuses on the standard care arm to explore differences in outcomes between sites, particularly the potential impact of offering meal replacements as part of usual care. Participants included individuals with a BMI ≥ 35 kg/m² and at least one obesity-related complication who received standard care at five SWMS sites. All sites provided specialist nutrition and exercise counselling; however, only the Dublin site (n = 40) included meal replacements as part of routine care. Baseline characteristics and weight change data were compared between the Dublin and UK cohorts (n = 92) at 52 and 104 weeks. Statistical comparisons were made using appropriate parametric and non-parametric tests. At baseline, the Dublin cohort was significantly older ( < 0.01), had a higher prevalence of hypertension ( < 0.05), and a lower reported incidence of depression/anxiety ( < 0.05) than the UK cohort. At week 52, the Dublin group achieved greater mean weight loss (-6.1%, SD ± 5.7%) compared to the UK cohort (-1.3%, SD ± 6.7%, n = 27, < 0.01). By week 104, Dublin participants maintained a mean weight loss of -4.4% (SD ± 5.7%) while UK participants had a mean weight gain of 0.37% (SD ± 7.6%) ( < 0.05). The integration of meal replacements as part of usual care may have contributed to the greater and sustained weight loss observed in the Dublin cohort compared to other SWMS in the UK.
STRIVE研究是一项多中心、开放标签的真实世界临床试验，旨在评估在英国和爱尔兰的专科体重管理服务（SWMS）机构中，使用3.0毫克利拉鲁肽作为标准治疗辅助手段的靶向处方途径与单纯标准治疗相比的有效性。这项事后分析聚焦于标准治疗组，以探究各研究点之间结局的差异，尤其是将代餐作为常规治疗一部分的潜在影响。参与者包括体重指数（BMI）≥35千克/平方米且至少有一种肥胖相关并发症、在五个SWMS研究点接受标准治疗的个体。所有研究点均提供专业的营养和运动咨询；然而，只有都柏林研究点（n = 40）将代餐纳入常规治疗。在52周和104周时，对都柏林队列（n = 40）和英国队列（n = 92）的基线特征和体重变化数据进行了比较。使用适当的参数检验和非参数检验进行统计比较。在基线时，都柏林队列比英国队列年龄显著更大（P < 0.01），高血压患病率更高（P < 0.05），而报告的抑郁/焦虑发生率更低（P < 0.05）。在第52周时，与英国队列相比，都柏林组实现了更大的平均体重减轻（-6.1%，标准差±5.7%），而英国队列的平均体重减轻为-1.3%（标准差±6.7%，n = 27，P < 0.01）。到第104周时，都柏林参与者的平均体重减轻维持在-4.4%（标准差±5.7%），而英国参与者的平均体重增加了0.37%（标准差±7.6%）（P < 0.05）。与英国其他SWMS研究点相比，将代餐纳入常规治疗可能是都柏林队列观察到更大且持续的体重减轻的原因。
