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.
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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