A randomized, double-blind, placebo-controlled trial of weight loss using liraglutide 3.0 mg for weight recurrence after Roux-en-Y gastric bypass.

Holly F Lofton, Gabrielle Maranga, Robert Hold, George Fielding, Heekoung Youn, Akash Gujral, Sean Heffron, Christine Fielding
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Abstract

Background: Bariatric surgery, such as Roux-en-Y gastric bypass (RYGB) remains the gold standard for treating obesity. Most people regain weight from postsurgery nadir.

Objectives: Liraglutide 3.0 mg is approved for weight management. This study will examine the effects on liraglutide 3.0 mg on weight regain post-RYGB.

Setting: University Hospital, United States.

Methods: A 56-week, double-blind, placebo-controlled study was conducted in 132 subjects, who achieved ≥25% total body weight loss (TBWL) status-post-RYGB and regained ≥10% TBWL after reaching nadir weight (NW). Subjects 18-120 months post-RYGB were randomized to receive liraglutide 3.0 mg/d (n = 89) or placebo (n = 43) with lifestyle counseling regularly for 56 weeks. The co-primary endpoints were the proportion of subjects losing at least 5%, 10%, and 15% TBWL and achieving weight lower than their NW.

Results: 53.4% of the placebo group and 65% of the liraglutide group completed the trial due to Severe acute respiratory syndrome coronavirus 2 pandemic. The change in %TBWL from baseline to 56-weeks was -8.8 (8.5, -29.2 to 9.7) and 1.1 (3.5, -7.9 to 5.99) in the liraglutide and placebo groups, respectively. 76% and 17% of subjects achieved ≥5% TBWL at 56 weeks in the liraglutide and placebo groups, respectively; 51% and 26.0% of the liraglutide group achieved ≥10% and ≥15% TBWL, respectively. None of the placebo group lost ≥10% TBWL. Twenty-one percent of subjects receiving liraglutide surpassed postoperative NW. No subjects on placebo met this goal. Nonserious adverse events occurred in 41.6% of subjects on liraglutide. Serious adverse events (SAE) occurred less often on liraglutide.

Conclusions: Liraglutide was significantly more effective than placebo in treating weight regain that occurs post-RYGB without increased SAE.

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使用利拉鲁肽 3.0 毫克治疗 Roux-en-Y 胃旁路术后体重复发的随机、双盲、安慰剂对照减肥试验。
背景:减肥手术,如 Roux-en-Y 胃旁路术(RYGB),仍然是治疗肥胖症的金标准。大多数人的体重会从手术后的最低点反弹:利拉鲁肽 3.0 毫克已被批准用于控制体重。本研究将探讨利拉鲁肽 3.0 毫克对 RYGB 术后体重反弹的影响:地点:美国大学医院:方法:在 132 名受试者中开展了一项为期 56 周的双盲安慰剂对照研究,这些受试者在 RYGB 术后达到≥25% 的总体重减轻(TBWL)状态,并在达到最低体重(NW)后恢复了≥10% 的总体重减轻(TBWL)。RYGB术后18-120个月的受试者随机接受利拉鲁肽3.0 mg/d(n = 89)或安慰剂(n = 43)治疗,并定期接受生活方式咨询,为期56周。共同主要终点是受试者TBWL至少下降5%、10%和15%以及体重低于其NW的比例:由于严重急性呼吸系统综合征冠状病毒 2 大流行,53.4% 的安慰剂组和 65% 的利拉鲁肽组完成了试验。从基线到56周,利拉鲁肽组和安慰剂组的TBWL%变化分别为-8.8(8.5,-29.2至9.7)和1.1(3.5,-7.9至5.99)。56周时,利拉鲁肽组和安慰剂组分别有76%和17%的受试者实现了≥5%的TBWL;利拉鲁肽组分别有51%和26.0%的受试者实现了≥10%和≥15%的TBWL。安慰剂组中没有人的 TBWL 下降≥10%。21%接受利拉鲁肽治疗的受试者超过了术后净体重。安慰剂组没有受试者达到这一目标。41.6%的利拉鲁肽受试者发生了非严重不良事件。利拉鲁肽的严重不良事件(SAE)发生率较低:结论:利拉鲁肽治疗RYGB术后体重反弹的效果明显优于安慰剂,且不会增加SAE。
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