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Obesity Abstracts (2021) 3 CD1.2 | DOI: 10.1530/obabs.3.CD1.2

OU2021 CASE DISCUSSIONS Case Discussions 1 (2 abstracts)

Liraglutide 3.0 mg within a NHS Tier-3/4 weight management service results in similar weight loss compared to regulatory trials – The LIPOSAX first UK real-world evidence study

Georgios K Dimitriadis 1, , Lewis Spencer 3 , Federica Dimitri 4 , Danielle Bate 5 , Bianca M Leca 5 , Aparna Duggirala 3 , Allan Davasgaium 5 , Simon JB Aylwin 1 , Alexander D Miras 6 , Royce P Vincent 1, , Carel W le Roux 7 , Mark Christian 4 , Harpal S Randeva 5 & Gyanendra Tripathi 3

1King’s College Hospital NHS Foundation Trust, London, United Kingdom; 2King’s College London, London, United Kingdom; 3University of Derby, Derby, United Kingdom; 4Nottingham Trent University, Nottingham, United Kingdom; 5UHCW NHS Trust, Coventry, United Kingdom; 6Imperial College London, London, United Kingdom; 7University College Dublin, Dublin, Ireland

Liraglutide 3 mg daily is an approved, prescription injectable GLP-1 receptor agonist, which can reduce weight in patients with obesity, with or without obesity complications. We conducted a 24-week, open-label real-world study involving 62 participants with a BMI >30 kg/m2 or >27 kg/m2 if they had co-existing dyslipidaemia or hypertension. No patients had type 2 diabetes. Patients received once-daily subcutaneous liraglutide 3.0 mg, alongside NHS Tier-3 lifestyle advice. The reduced calorie diet was based on individual estimated basic metabolic rate. The primary end point was change in body weight. Secondary outcomes included changes in anthropometrics and circulating biomarkers of metabolism (metabolomics and miRNAs). For miRNA analysis, participants were categorised into responders (>5% weight loss) and non-responders (<5% weight loss). Ten miRNAs were analysed (including miR-424, miR-143, miR-222, miR-103 and miR-146b). RNA was isolated using miRNeasy and reverse transcribed into cDNA using miRCURY. Cel-miR-39-3p and Unisp6 spike-ins were used as controls. Their geometric mean was used to normalise miRNA expression by the calculated 2^-Δct values. Final analysis included 49 patients. At baseline, 87.1% of participants were women, patients were aged 38.6±9.8 years (mean ± SD), weighed 117.5±24.5 kg, had fat-mass of 58.96±15.91 kg and BMI of 41.33±6.9 kg/m2. Fasting glucose was 5.3±0.58 mmol/l, and ALT 24.9±12.6 U/l. At week 24, patients lost 12.85±8.4 kg or 9.9±5.8 % body weight (P<0.001) and fat-mass decreased by 11.27±7.88 kg (P<0.001). 55.1% of patients lost 5-10% and 18.4% lost >10% body weight (P<0.001). Fasting glucose reduced by 0.7±0.7 mmol/l (P<0.001) and ALT by 8.8±12 U/l (P<0.005). Good responders had downregulation of miR-424 (P<0.001) whilst poor responders had upregulation of miR-424 (P<0.01). There were no changes in other miRNAs. The most frequently reported adverse events were mild to moderate nausea and diarrhoea. There were no serious adverse events. In this study, 3.0 mg of liraglutide, as an adjunct to a reduced calorie diet and increased physical activity offered within a UK NHS Tier-3/4 weight management service, was associated with reduced body weight and improved metabolic control similar to what has been reported by regulatory trials.

Volume 3

Obesity Update 2021

Online, United Kingdom
30 Jun 2021 - 01 Jul 2021


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