Acceso usuarios
Antelm Pujol Calafat, Juana Ana Nicolau Ramis, Apolonia Gil, Jorge Blanco Anesto
Introducción: casi dos tercios de los pacientes en tratamiento con 3 mg de liraglutida no lograran los objetivos de pérdida de peso, lo que lleva a la búsqueda de otras opciones farmacológicas. El STEP 8 demostró la superioridad de la semaglutida, 2,4 mg/semana, en comparación con la liraglutida, 3 mg/día. Evaluamos los efectos de 0,5 mg de semaglutida sc semanal en comparación con 3 mg de liraglutida/día en personas con obesidad (PwO) sobre los parámetros antropométricos en la vida real durante 3 meses. Métodos: 179 PwO (91,9 % mujeres, 45,7 ± 10 años e IMC de 33,3 ± 7 kg/m2) recibieron tratamiento con aGLP-1 e intervenciones en el estilo de vida y fueron evaluadas retrospectivamente al inicio y después de 3 meses. A 99 pacientes se les prescribió semaglutida sc, 0,5 mg semanales, con indicación fuera de la ficha técnica para reducción del peso, y se les comparó con 80 pacientes tratados con 3 mg día de liraglutida sc. Se estudió la evolución de los parámetros antropométricos y de composición corporal en ambos grupos. Resultados: las PwO experimentaron una reducción significativa del peso con la semaglutida sc en dosis de 0,5 mg semanales (96,67 ± 20,83 vs. 91,44 ± 19,6 kg; p < 0,01) y la liraglutida en dosis de 3 mg al día (90,73 ± 21,88 vs. 80,13 ± 18,38 kg; p < 0,01). No se observaron diferencias significativas entre los grupos en la cantidad de peso perdida ni en términos de la masa grasa ni de la masa libre de grasa. Conclusión: tanto la semaglutida en dosis de 0,5 mg y como la liraglutida en dosis de 3 mg son tratamientos eficaces y seguros para reducir el peso en las PwO sin impacto negativo sobre la masa magra. Además, en la vida real, las dosis bajas de semaglutida fueron similares a las de 3 mg de liraglutida para reducir el peso corporal a corto plazo.
Background: the prevalence of obesity is reaching a pandemic status. The SCALE trials showed that liraglutide 3 mg among people with obesity (PwO) was effective to reduce bodyweight and related complications. The fact that almost two-thirds of patients did not achieve the desired weight loss with the maximum dose of liraglutide made almost mandatory the development of other pharmacological options. The STEP 1-5 trials showed the effectiveness of semaglutide in reducing bodyweight in a dose-dependent manner. Moreover, the STEP 8 trial proved the superiority of semaglutide 2,4 mg/week versus liraglutide 3 mg/daily. We aimed to assess the effects of subcutaneous (s.c.) semaglutide 0.5 mg/weekly compared with s.c. liraglutide 3 mg/daily in PwO on anthropometric parameters in a real world-scenario for 3 months.
Methods: we retrospectively evaluated 179 PwO (91.9 % ♀, 45.7 ± 10 years, and 33.3 ± 7 kg/m2 ) who received treatment with aGLP-1 as add-on therapy to lifestyle interventions. Patients were evaluated at baseline and after 3 months. Ninety-nine patients were prescribed s.c. semaglutide 0.5 mg/weekly with an off-label indication for weight reduction. These patients were compared with 80 patients treated with s.c. liraglutide 3 mg/daily. The main reason for prescribing of s.c. semaglutide was economic. Body composition was evaluated using a bioimpedance device (Tanita MC 580M®).
Results: baseline weight was significantly greater with semaglutide compared to liraglutide (97.19 ± 21.09 vs. 90.73 ± 21.88 kg; p < 0.01) as was fat mass (42.43 ± 15.04 vs. 34.84 ± 16.07 kg; p < 0.01), whereas baseline lean mass was lesser among subjects treated with semaglutide (31.62 ± 7.56 vs 45.69 ± 15.51 kg; p < 0.01). PwO experienced a significant reduction in weight using s.c. semaglutide 0.5 mg/weekly (96.67± 20.83 vs. 91.44 ± 19.6 kg; p < 0.01) or s.c. liraglutide 3 mg/daily (90.73 ± 21.88 vs. 80.13 ± 18.38 kg; p < 0.01) No significant differences were seen between the amount of weight lost (5.28 ± 4.22 vs 5.72 ± 1.62 kg; p = 0.5) in the two groups. Furthermore, both groups were comparable in fat mass (2.69 ± 5.34 vs 0.96 ± 4.22 kg; p = 0.3) and fat-free mass (0.86 ± 1.63 vs 1.03 ± 0.94 kg;p = 0.07) after 3 months of treatment with both aGLP1. Side effects were gastrointestinal and transient/comparable between groups.
Conclusions: subcutaneous semaglutide 0.5 mg and subcutaneous liraglutide 3 mg are effective treatments for reducing weight safely among PwO in a real-world scenario at short term and without a negative impact on fat-free mass. Moreover, low doses of semaglutide were similar to liraglutide 3 mg in reducing bodyweight at short term.
