Weight maintenance on cost-effective antiobesity medications after 1 year of GLP-1 receptor agonist therapy: a real-world study.

Nina U Paddu, Brianna Lawrence, Sydnee Wong, Sabrina J Poon, Gitanjali Srivastava
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Abstract

Objective: The high cost of novel glucagon-like peptide-1 receptor agonist (GLP-1 RA) class agents often limits access and creates barriers to care. This real-world study evaluated the efficacy of older-generation generic antiobesity medications (AOMs) for weight maintenance after 1 year of GLP-1 RA therapy in patients who had achieved successful weight loss.

Methods: We prospectively followed patients (N = 105) who had completed 12 months of therapy and were part of a "medical weight loss bundle," which included 12 months of GLP-1 RA therapy followed by 6 months of transition care. The baseline mean BMI was 36.4 kg/m2. Body weight outcomes were measured at 6, 12, 18, and 24 months.

Results: After the medical weight loss bundle, 40 patients transitioned to generic AOMs. At 12 months, this cohort lost an average of 18.3%, 95% CI [13.0%, 23.6%] body weight from baseline, with a mean BMI of 27.9 kg/m2. At 18 months, they maintained the weight loss, with a mean BMI of 27.9 kg/m2. Subsequent follow-up visits (average 1.5 months later) without GLP-1 RAs showed further reduction, resulting in a total average weight loss of 25.5%, 95% CI [23.1%, 27.9%] compared to the initial visit.

Conclusions: Patients successfully treated with GLP-1 RAs can maintain their weight loss using generic older-generation AOMs, suggesting potential cost savings for insurers and implications for policy regarding AOM coverage.

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GLP-1 受体激动剂治疗 1 年后使用经济有效的抗肥胖药物维持体重:一项真实世界研究。
目的:新型胰高血糖素样肽-1受体激动剂(GLP-1 RA)类药物的高昂价格往往限制了患者的使用,并给治疗带来了障碍。这项真实世界研究评估了已成功减轻体重的患者在接受 GLP-1 RA 治疗一年后使用老一代普通抗肥胖药物(AOMs)维持体重的疗效:我们对已完成 12 个月治疗的患者(N = 105)进行了前瞻性随访,这些患者属于 "医疗减重捆绑 "的一部分,其中包括 12 个月的 GLP-1 RA 治疗和 6 个月的过渡护理。基线平均体重指数为 36.4 kg/m2。体重结果在 6、12、18 和 24 个月时进行测量:结果:在接受医疗减重捆绑治疗后,40 名患者转为接受普通 AOMs 治疗。12 个月时,这些患者的体重与基线相比平均下降了 18.3%,95% CI [13.0%, 23.6%],平均体重指数(BMI)为 27.9 kg/m2。18 个月后,他们的体重保持不变,平均体重指数为 27.9 kg/m2。随后的随访(平均 1.5 个月后)显示,未使用 GLP-1 RAs 的患者体重进一步下降,与首次随访相比,总平均体重下降了 25.5%,95% CI [23.1%, 27.9%]:结论:使用GLP-1 RAs治疗成功的患者可以使用普通的老一代AOMs维持体重减轻,这表明保险公司有可能节约成本,并对AOM的覆盖政策产生影响。
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