Study supports GLP-1 agonists for weight loss
pharmafile | January 10, 2012 | News story | Research and Development, Sales and Marketing | GLP-1, Novo Nordisk, Sanofi, diabetes, lilly
An independent study by academics has concluded that GLP-1 agonist drugs help patients to lose weight – with the effect most striking in those without diabetes.
Glucagon-like peptide-1 (GLP-1) is a hormone that is secreted from the intestine when we eat, and helps regulate blood sugar levels.
Researchers at the University of Copenhagen examined how GLP-1 agonists affect weight loss, and also looked at the effect on blood pressure, cholesterol and liver enzyme levels, and blood sugar control.
As well as regulating blood sugar levels, GLP-1 based therapy is known to suppresses appetite and food intake, raising interest in them as a potential obesity treatment.
The researchers pooled data from numerous trials of two GLP-1 agonist treatments which on the market – Lilly’s Byetta (exenatide) and Novo Nordisk’s Victoza (liraglutide)
They analysed the results of 25 randomised controlled trials involving over 6,000 patients. Differences in study design and quality were taken into account to minimise bias.
The study published on BMJ.com found patients who received clinically relevant doses of GLP-1R agonists for at least 20 weeks achieved a greater weight loss compared with the control groups.
The researchers say benefit were seen for patients with and without type II diabetes, but may be more pronounced in patients without diabetes. GLP-1R agonists also had beneficial effects on blood pressure, cholesterol and improved glycaemic control in patients with type II diabetes. There was no statistically significant effect on liver enzymes.
Common side effects included nausea, vomiting and diarrhoea, but did not seem to affect the number of patients dropping out of the trials, suggesting that overall patient satisfaction with the treatment is relatively high.
The authors say that their analysis “provides convincing evidence that GLP-1R agonists, when given to obese patients with or without diabetes, result in clinically relevant beneficial effects on body weight. Additional beneficial effects on blood pressure and total cholesterol might also be achieved.”
They say the drugs should be considered in patients with diabetes who are obese or overweight, and call for further studies to clarify the effects of GLP-1R agonists in treating obese patients without diabetes.
The results should not alter current practice, however, says Professor Raj Padwal from the University of Alberta in an accompanying editorial. He argues that “modification of diet and lifestyle remains the cornerstone of the treatment of type II diabetes.”
He also points out that the safety of GLP-1 agonists is still unknown and says “continued and close surveillance of these new agents using all available data sources is warranted.”
Other researchers have preached caution in relation to GLP-1s, which other studies have linked with pancreatitis, pancreatic and thyroid cancers also in humans.
Responding on the BMJ website, Jose Mario Franco de Oliveira, associate professor of medicine at the Universidade Federal Fluminense in Rio de Janeiro in Brazil, said longer term studies comparing GLP-1s to established treatments were needed.
Novo Nordisk re-initiated phase III trials of Victoza in treating obesity in early 2011, in a study of around 5,000 patients.
Andrew McConaghie
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