Pivotal Results for Semaglutide in Obesity

Yesterday the process of a slow reveal began. Novo Nordisk released the first pivotal results in studies of semaglutide for obesity. This new drug, already available for diabetes, has potential to bring us closer to truly effective obesity treatment without surgery. This was merely a first glimpse – topline results from only one of four studies that will tell the full story. But that glimpse did not disappoint.

After 68 weeks, patients receiving semaglutide 2.4 mg weekly sustained a 17 percent weight loss. This looks better than any of the currently available drugs for obesity. Moreover, it looks like a step toward delivering efficacy comparable to bariatric surgery, but with drug therapy.

Sustained Benefits

Make no mistake about it. Developing this drug is a huge effort with high expectations for it. The present study enrolled 902 patients and followed them for 68 weeks. The primary goal was to demonstrate that continuing with the drug meant sustained weight loss and health benefits. After 20 weeks of treatment, the study randomly assigned patients to keep taking the drug or to discontinue it.

The results were clear. People who kept taking semaglutide maintained the weight they had lost, plus more. Those who stopped, regained weight.

Just like hypertension, obesity is a chronic condition. When you have an effective drug, it only works while you’re taking it. Stop taking it and the drug stops working.

Topline Results from One of Four Studies

It’s important to note a few things. As impressive as these results are, they are only part of a picture that’s still emerging. The pivotal phase three program for semaglutide in obesity includes three other studies. In addition, remember that these results are only toplines. We’ll want to look very closely at a peer-reviewed publication of the full results. GI side effects appear to be the major downside.

We should have a fuller picture later this year. If all goes well, this new treatment will be going to FDA for approval shortly afterward. That could mean an approval before the end of 2021.

This is good news without a doubt. Obesity is a relentless condition that affects many people. We have some medical tools for managing it, but they fall short of what patients need. Semaglutide might be one step toward better options and better health for many people.

Click here for the results posted by Novo Nordisk and here for further background.

Blanket, sanguine drawing by Boris Kustodiev / WikiArt

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May 14, 2020

4 Responses to “Pivotal Results for Semaglutide in Obesity”

  1. May 14, 2020 at 12:10 pm, David Brown said:

    Semaglutide “induces weight loss by reducing hunger, increasing feelings of fullness and thereby helping people eat less and reduce their calorie intake.”

    One can accomplish the same thing without semaglutide by reducing intake of linoleic acid and arachidonic acid.

    Taken together, this study indicates that in overweight/obese individuals, high-linoleic acid meals may promote excess energy intake and alter glucose handling, though a larger cohort may be required to strengthen results.

    • May 14, 2020 at 2:44 pm, Ted said:

      Unfortunately, David, the study you cite does not support the claim that reducing linoleic and arachidonic acid intake can accomplish the same thing as semaglutide. It’s a study of the effects of a single meal on hunger. The data on semaglutide is an RCT where patients are followed for 68 weeks and shown to lose weight. No weight loss at all was measured in the linoleic acid study. It included only 8 subjects, whereas the semaglutide study included 902.

      In no way are these two interventions comparably effective.

  2. May 16, 2020 at 10:21 pm, A. F. said:

    I would like to say that I was extremely happy with the results I had with Saxenda. I was on this medication for 1 1/2 years and went from 208lbs to 164lbs (and still loosing) and felt awesome. I had more energy, less pain in my feet and siciati nerve and able to be more active with my activities. It was wonderful but then the ins I had changed their formulary and I was not able to get the medicine any longer. Since being off Saxenda I have gained back most of my weight, my pain has returned and my energy level has lessened. I am a nurse and had tried all diets, OTC medications and exercise with no results of weight loss. I miss using the Saxenda medication and I have also mentioned it to many people who have had wonderful results as well. Thank you for creating such a medicine that can help people like me feel and live better.

    • May 17, 2020 at 3:29 am, Ted said:

      I’m frustrated to hear that your insurance formulary would do that. It’s simply wrong.