Endocrine Abstracts

Context: Recent data from controlled clinical trials have demonstrated that GLP-1 agonists are a well-tolerated therapy-option for weight loss in obese patients without type 2 diabetes mellitus.

Objective: To investigate whether continuation of treatment, side-effects and effect on weight loss of GLP-1 agonists are equally promising in dairy clinical practice settings in non-diabetics.

Methods: Obese, non-diabetic patients of our interdisciplinary obesity centre were treated off-label with GLP-1 agonists. Application was started low dose and increased if side effects were tolerable. Monthly costs were 125 Euros for daily applications of 1.2 mg Liraglutide or 10 mg Exenatide twice daily. Data were obtained by telephone interviews about base-line characteristics, weight loss, sensation of satiation, duration of therapy, side-effects and reasons for discontinuation.

Results: Of 43 included cases (five males, mean age 43±11 years, mean weight 107±24 kg, mean excess weight 35±21 kg), seven were treated with Exenatide and 36 with Liraglutide. Excess weight loss in linear regression models was 6.7% per months under control of age, sex, initial weight and type of GLP-1-analogon treatment and did not significantly differ between Liraglutide and Exenatide. 58% of patients reported side-effects mostly concerning the gastrointestinal tract. Surprisingly no patient reported vomiting. Two severe side-effects (pancreatitis and first manifestation of systemic lupus erythematodes) occurred. At time of telephone interview only 30.2% were continuing treatment. Mean treatment duration was 2.98±2.71 months. Common reasons for discontinuation of treatment were no/little effect on weight loss (27.9%), intolerable side-effects (20.9%) or financial reasons (14%).

Conclusion: GLP 1 agonist treatment in obese non-diabetics also correlate with significant weight loss in clinical practice. However side-effects and discontinuation of treatment are common. Therefore long-term effect on weight-loss might not be as promising as suggested by data from clinical trials.