Semaglutide for weight loss
In 4 RCTs, patients were treated for weight loss with 2.4 mg of subcutaneous SGT weekly and lifestyle interventions (counseling, diet, and physical activity) and the AEs were similar between doses.
Abstract
Evidence Differences were statistically significant unless noted. • In 4 RCTs, patients (baseline weight 96 to 105 kg) were treated for weight loss with 2.4 mg of subcutaneous SGT weekly and lifestyle interventions (counseling, diet, and physical activity).1-4 An RCT of nondiabetic patients (N = 1961)1: After 68 weeks, mean weight loss was 15% (15 kg) versus 2% (3 kg) PC. The proportion of those who lost weight (≥ 5%) was 86% versus 32% (PC), with a number needed to treat (NNT) = 2, while the proportion who lost more weight (≥ 10%) was 69% versus 12% (PC), NNT = 2. Weight loss plateaued around week 60. —Gastrointestinal adverse effects (AEs): 74% versus 48% (PC), number needed to harm (NNH) = 3. Withdrawals due to AEs were 7% versus 3% (PC), NNH = 25. -Similar results in an RCT (N = 611) of SGT with intensive lifestyle interventions: 16% (17 kg) versus 6% (6 kg) PC.2 Dose-finding RCT3 of diabetic patients (N = 1210) given either 2.4 mg of SGT weekly, 1.0 mg of SGT weekly, or PC: After 68 weeks, mean weight loss was 10% (2.4 mg), 7% (1.0 mg), and 3% (PC). Proportion who lost weight (≥ 5%) was 69% (2.4 mg) versus 57% (1.0 mg) versus 29% (PC). For 2.4 mg versus 1.0 mg, NNT = 9. —The AEs were similar between doses. Weight-maintenance RCT (N = 803)4: Nondiabetic participants were given 2.4 mg of SGT weekly for 20 weeks and then randomized to either continued SGT or PC. After 48 weeks, the continued SGT group lost 8% body weight compared with a 7% weight gain in the PC group.