In overweight or obese patients with prediabetes, the addition of liraglutide (Saxenda; Novo Nordisk) 3mg to diet and exercise may result in major health improvements, according to a study presented at ENDO 2016.

Ken Fujioka, MD, lead study author, conducted a Phase 3a SCALE (Satiety and Clinical Adiposity – Liraglutide Evidence) Obesity and Pre-diabetes trial in adults without diabetes who have obesity, and adults without diabetes who are overweight with weight-related comorbidities. They found that subcutaneous (SC) liraglutide 3mg for 3 years in combination with a reduced-calorie diet and physical activity can lower the risk the type 2 diabetes, improve cardiometabolic risk factors, reduce weight, which may ultimately reduce the risk of cardiovascular disease.

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Dr. Fujioka and colleagues studied 2,254 overweight and obese adult patients who also had either high cholesterol or high blood pressure or both. Patients were randomized to liraglutide 3mg (n=1,505) or placebo (n=749); all patients were on a reduced-calorie diet and participated in 150 min/week of physical activity and were given counseling.

After 3 years, results showed that patients taking liraglutide lost more weight than those taking placebo (6.1% vs. 1.9%, respectively), and reduced their risk of type 2 diabetes. Also, more patients in the liraglutide group returned to normoglycemia than patients in the placebo group (66% vs. 36%). Overall, patients treated with liraglutide saw their blood glucose levels return to normal as well as a decrease in waist circumference (estimated treatment difference [ETD] –3.5cm). In regards to cardiometabolic risk factors, patients in the liraglutide group had a greater decrease in systolic blood pressure (ETD –2.8mmHg; P<0.0001), and a greater improvement in triglycerides (–6%; P=0.0003), and total cholesterol levels (ETD –2%; P=0.03) compared to placebo.

Study authors noted the rate of adverse events and serious adverse events were similar for both groups.

Saxenda is a glucagon-like peptide-1 (GLP-1) receptor agonist currently approved as adjunct to reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial BMI of ≥30kg/m2 (obese), or ≥27kg/m2 (overweight) in the presence of at least one weight-related comorbid condition (eg, hypertension, T2DM, dyslipidemia).

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