司美格鲁肽2.4毫克治疗肥胖或超重患者的临床结局：一项真实世界回顾性比较队列研究。

Semaglutide 2.4 mg Clinical Outcomes in Patients with Obesity or Overweight: A Real-World Retrospective Comparative Cohort Study.

作者信息

Ruseva Aleksandrina, Michalak Wojciech, Fabricatore Anthony, Hartaigh Bríain Ó, Zhao Zhenxiang, Umashanker Devika

机构信息

Novo Nordisk Inc., 800 Scudders Mill Rd, Plainsboro, NJ, 08536, USA.

Hartford HealthCare, Hartford, CT, USA.

出版信息

Adv Ther. 2025 Aug 6. doi: 10.1007/s12325-025-03320-6.

DOI:10.1007/s12325-025-03320-6

PMID:40768189

Abstract

INTRODUCTION

This study compared the effectiveness of semaglutide 2.4 mg vs. no treatment with obesity medication (OM) for reducing weight and improving cardiometabolic risk factors among adults with obesity or overweight.

METHODS

This real-world, retrospective, observational cohort study included adults with obesity or overweight with ≥ 1 obesity-related complication treated with semaglutide 2.4 mg identified in a large US claims and medical record database (December 15, 2020, through May 30, 2024). Patients were matched 1:4 to non-treated patients using a propensity score (PS) model. Change in weight and body mass index (BMI) (primary outcomes) and changes in cardiometabolic risk factors (secondary outcomes; systolic blood pressure [SBP], diastolic blood pressure [DBP], glycated hemoglobin [HbA1c], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], and triglycerides) were assessed from baseline to 12 months. PS matching and generalized linear models were used to compare outcomes.

RESULTS

A total of 8,857 semaglutide 2.4 mg-treated patients were matched to 35,428 non-treated patients. After matching, baseline characteristics between cohorts were well balanced in mean age (47.6 vs. 47.8 years), mean BMI (36.7 kg/m in both cohorts), and gender (76% vs. 77% female). Weight data were available for 4,038 and 1,186 patients in the non-treated and semaglutide cohort, respectively. Estimated treatment differences between cohorts showed the semaglutide 2.4 mg cohort had significantly greater percentage (- 15.0%) and absolute reduction in weight (- 15.7 kg), greater reduction in BMI (- 4.2 kg/m), and significantly greater improvements in cardiometabolic risk factors, including SBP (- 6.7 mmHg), DBP (- 2.7 mmHg), HbA1c (- 0.5%), HDL-C (1.2 mg/dl), LDL-C (- 10.4 mg/dl), and triglycerides (- 34.3 mg/dl) at 12 months.

CONCLUSION

In this real-world study, adults with obesity or overweight treated with semaglutide 2.4 mg had greater reductions in weight and improvements in cardiometabolic risk factors compared with patients not treated with OM at 12 months. A Graphical Abstract is available for this article.

摘要

引言

本研究比较了2.4毫克司美格鲁肽与不使用肥胖症药物（OM）治疗对肥胖或超重成年人减轻体重和改善心血管代谢危险因素的效果。

方法

这项真实世界、回顾性、观察性队列研究纳入了在一个大型美国索赔和医疗记录数据库（2020年12月15日至2024年5月30日）中识别出的接受2.4毫克司美格鲁肽治疗且患有≥1种肥胖相关并发症的肥胖或超重成年人。使用倾向评分（PS）模型将患者按1:4与未治疗患者进行匹配。评估从基线到12个月时体重和体重指数（BMI）的变化（主要结局）以及心血管代谢危险因素的变化（次要结局；收缩压[SBP]、舒张压[DBP]、糖化血红蛋白[HbA1c]、高密度脂蛋白胆固醇[HDL-C]、低密度脂蛋白胆固醇[LDL-C]和甘油三酯）。采用PS匹配和广义线性模型比较结局。

结果

共有8857例接受2.4毫克司美格鲁肽治疗的患者与35428例未治疗患者进行了匹配。匹配后，队列之间的基线特征在平均年龄（47.6岁对47.8岁）、平均BMI（两组均为36.7kg/m²）和性别（女性分别为76%对77%）方面达到了良好的平衡。未治疗组和司美格鲁肽组分别有4038例和1186例患者有体重数据。队列之间估计的治疗差异显示，2.4毫克司美格鲁肽组的体重百分比下降幅度（-15.0%）和绝对下降幅度（-15.7千克）显著更大，BMI下降幅度更大（-4.2kg/m²），心血管代谢危险因素的改善也显著更大，包括12个月时的SBP（-6.7mmHg）、DBP（-2.7mmHg）、HbA1c（-0.5%）、HDL-C（1.2mg/dl）、LDL-C（-10.4mg/dl）和甘油三酯（-34.3mg/dl）。