Post-Bariatric Patients See More Benefits With Semaglutide vs Liraglutide

SAN DIEGO -- A 1-mg dose of semaglutide (Wegovy) weekly was better at maintaining weight than 3-mg liraglutide (Saxenda) daily for patients who put on pounds after bariatric surgery, a retrospective study suggested.

Among 207 patients who had weight recurrence after surgery, the least square mean change in body weight from baseline to 1 year was -12.92% with semaglutide compared with -8.77% with liraglutide (P<0.001), reported Jaime P. Almandoz, MD, MBA, of the University of Texas Southwestern Medical Center in Dallas, and colleagues during the Obesity Week annual meeting.

Patients who took semaglutide versus liraglutide were also more likely to experience weight loss of 10% or more at 1 year (50.4% vs 32.6%; adjusted OR 2.34, 95% CI 1.28-4.29), as well as weight loss of 15% or more (27.8% vs 15.2%; aOR 2.55, 95% CI 1.22-5.36).

Of note, this study took place before semaglutide was FDA-approved in June 2021 at a dose of 2.4 mg.

It's very common for bariatric patients to gain weight back following surgery, Almandoz told MedPage Today. "You can imagine that if we intervene earlier, we could help people to maintain a healthier weight in the long term."

"This really speaks to the effectiveness of glucagon-like peptide-1 receptor agonist-based therapies such as semaglutide for treating obesity, especially with regard to weight recurrence," he noted, adding that weight-loss drug trials typically exclude bariatric surgery patients.

"This is not to say that liraglutide is not effective. Liraglutide is very effective," he said. Still, researchers were surprised that semaglutide performed better even at a lower-than-standard dose, he added, pointing out that this is good news since some patients turn to lower doses of the drug, which is highly expensive but usually not covered by insurance.

For this study, Almandoz and team used electronic health record data on 207 patients who were treated for weight gain following bariatric surgery from January 2015 to April 2021. Mean age was 52.5 years, 89.9% were women, 46.4% were white, and 34.8% were Black. Mean BMI was 40.4. Outcomes did not differ by sex, age, or race/ethnicity.

Of these patients, 50% underwent sleeve gastrectomy, 29% underwent Roux-en-Y gastric bypass, and 21% underwent adjustable gastric banding.

They were treated for weight recurrence with 1-mg weekly semaglutide or 3-mg daily liraglutide for 12 months.

While this study didn't address side effects, users of both drugs commonly experience gastrointestinal problems.

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