Endocrine Abstracts

Introduction: Weight gain and its associated adverse health consequences have become a significant aspect of the life experience of many people with schizophrenia and other severe enduring mental illnesses (SMIs). Glucagon-like peptide -1(GLP-1) receptor agonists could be of substantial value in addressing this unmet need. We aimed to determine whether semaglutide treatment is feasible and acceptable to individuals in an inpatient setting and successful in facilitating weight reduction in overweight individuals with schizophrenia.

Methods: 10 people (6 men and 4 women) with a diagnosis of schizophrenia/schizoaffective disorder according to ICD-10 with a body-mass index (BMI) of at least 30 kg/m2 were commenced on the GLP-1 agonist semaglutide, administered as per BNF in increasing dose increments up to a maximum dose of 2.4 mg/week. Body mass index (BMI) and glycated haemoglobin (HbA1c) were assessed at baseline and 6-week follow-up. Concerning patient-reported outcome measures (PROMs), we assessed the quality of life using the EQ5D5L rating scale.

Results: Age range was 32-52 years. Baseline BMI was 33.5kg/m2 (range 30.5-38,8). At 6-week follow-up, there was a 6% (95% confidence interval (CI) 4.2-7.8%) reduction in BMI, P = 0.009. Mean HbA1c decreased from 42 mmol/mol (95% CI 40-45) to 40 mmol/mol (95% CI 38-43), P = 0.01. EQ5D5L visual analogue rating (VAR) scale showed a mean improvement from 52-61 (out of 100) with an improvement in the mobility domain score. All individuals stated that they wished to continue the treatment.

Conclusions: Already at 6-week follow-up, we have seen a reduction in BMI and HbA1c and improvement in self-rated overall quality of life in people with schizophrenia. While there are costs attached to the prescription of GLP-1 agonists in people with SMI, further evaluation including health economic assessment may support this treatment being offered more widely to improve cardio-metabolic profile and long-term health outcomes in people with SMI.