More Options & Better Outcomes for Obesity Medicine?

Tuesday is obesity medicine day for National Obesity Care Week. And it just so happens that we have two new studies on the subject in the Lancet. They point to a trend. Day by day, we see evidence of more options and better outcomes for medical obesity care.

A New Dual-Receptor Agonist

Juan Frias and colleagues published phase II study results on a new drug from Lilly. It’s a dual receptor agonist. Its effect comes from activating both GLP-1 and GIP receptors. It appears to be effective for both type-2 diabetes and obesity. Not only did they publish their findings in Lancet, they also presented them at the European Association for the Study of Diabetes (EASD) meeting in Berlin.

Make no mistake, these are early results that need confirmation in bigger studies. But these early results are encouraging. They found a better effect on both diabetes and body weight than a GLP-1 agonist, dulaglutide. Lilly sells dulaglutide under the brand name Trulicity.

This was a six-month study to test a range of four different doses of the new drug. At the highest dose, patients lost an average of 12.7 percent of their initial body weight after 26 weeks. However, you should note that this was primarily a study of treating type 2 diabetes. The average BMI of patients in this study was a bit over 32. But it included patients with BMI less than 25. So it wasn’t really an obesity study. Effects on weight were secondary outcomes.

Lilly is still evaluating whether to pursue an obesity indication. But in a commentary published alongside the study in Lancet, Michael Stumvoll and Matthias Tschöp are cautiously optimistic. Dual and triple agonists might point the way to metabolic precision medicine, they say.

The good news here is the possibility of more options for treating obesity and thus, eventually, better outcomes for patients.

A 19% Reduction in Diabetes

The second study in Lancet is a large outcomes study for lorcaserin (Belviq). Back in August, NEJM published the overall safety and cardiovascular outcomes from this study. But now we have the study of outcomes for type 2 diabetes, and it’s more good news. In patients with prediabetes, lorcaserin cut the risk of diabetes by 19 percent. In patients without diabetes, it cut the risk by 23 percent. Among patients who already had diabetes, blood sugar control improved – mainly because of better weight control.

We’ve said it before. These results are not a dramatic breakthrough. But they are a solid indication that effective medical obesity treatment can bring better outcomes for patients.

With the advent of more options, we will soon have the tools to more precisely tailor medical obesity care to the needs of each patient.

Click here for the dual agonist study and here for the lorcaserin study. Click here and here for the commentaries that go with them.

Options, photograph © Thomas Hawk / flickr

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October 9, 2018