Semaglutide – a viable solution for treating obesity?
Obesity is a global health challenge with few pharmacological options. For the first time, on March 18, at ENDO 2018, at the annual meeting of the Endocrinology Society of Chicago, a study was presented that showed that a compound that mimics a hormone that occurs naturally in the body and regulates appetite (GLP-1) could help people suffering from obesity, but not necessarily diabetes.
The compound we are referring to is called semaglutide and has a structure similar to that of a hormone that regulates insulin secretion in the body, but also appetite, called GLP-1.
At the end of 2017, the US Food and Drug Administration approved an injection containing semaglutide, called Ozempic, to be used as an adjunct once a week along with diet and exercise and to optimize blood glucose control in adults with type 2 diabetes.
Obesity is a chronic disease and a global public health challenge and can lead to insulin resistance, hypertension and dyslipidemia, is associated with complications such as type 2 diabetes, cardiovascular disease and non-alcoholic fatty liver disease and reduces life expectancy. More recently, in the current context of COVID-19, obesity has been linked to an increased number of hospitalizations, the need for mechanical ventilation and death in people with coronavirus.
Although lifestyle intervention (diet and exercise) is the cornerstone of weight management, sustaining long-term weight loss is a challenge. We are talking about obesity when the body mass index (BMI) – i.e. the number of kilograms divided by the square of the height in meters – has a value of 30 or more or 27. The medication to treat obesity remains limited and modestly effective.
As mentioned above, semaglutide is a glucagon-like peptide 1 (GLP-1) analogue that is approved at doses up to 1 mg given subcutaneously once a week for the treatment of type 2 diabetes in adults and to reduce the risk of cardiovascular events in people with type 2 diabetes and cardiovascular disease. In a phase 2 study, semaglutide induced weight loss in people with type 2 diabetes and obese adults who participated in the study, findings that attracted attention and supported further investigations. The Phase 3 Global Program, entitled ‘Effect of Semaglutide Treatment in Obese Persons’, aims to evaluate the efficacy and safety of semaglutide administered subcutaneously at a dose of 2,4 mg/week, for overweight or obese patients.
This 68-week study evaluated the efficacy and safety of semaglutide, compared to placebo, as an adjunct to lifestyle intervention to reduce body weight and meet other endpoints related to overweight or obese adults without diabetes.
Adults with a body mass index of 30 or higher (≥27 in people with ≥1 coexisting weight-related condition), who did not have diabetes and were randomly assigned to the study, were enrolled (ration of 2:1) in 68 weeks of treatment with subcutaneous semaglutide once a week (at a dose of 2.4 mg) or placebo, plus lifestyle intervention. The coprimary endpoints were the percentage change in body weight and the reduction in weight of at least 5%. The primary estimate (a precise description of the effect of the treatment that reflects the objective of the clinical trial) assessed the effects, regardless of treatment discontinuation or rescue interventions.
The mean change in body weight from baseline to week 68 was -14.9% in the semaglutide group, compared to -2.4% in placebo, for an estimated difference in treatment of -12.4%. Participants who received semaglutide had an improvement in cardiometabolic risk factors and an increase in physical function reported by participants at baseline, rather than those who received placebo.
THE CONCLUSIONS of this study were: in participants with overweight or obesity, 2.4 mg of semaglutide once a week, plus lifestyle intervention, was associated with a sustained, clinically relevant reduction in body weight. We emphasize the intervention in lifestyle, including physical activity. The Dahna app can be an ally for those who want to make lifestyle changes. We invite you to download it for free from the AppStore or Google Play!