![]() Semaglutide is a glucagon-like peptide-1 (GLP-1) analogue that is approved, at doses up to 1 mg administered subcutaneously once weekly, for the treatment of type 2 diabetes in adults and for reducing the risk of cardiovascular events in persons with type 2 diabetes and cardiovascular disease. 1,2,10 However, the use of available medications remains limited by modest efficacy, safety concerns, and cost. 9 Clinical guidelines suggest adjunctive pharmacotherapy, particularly for adults with a body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) of 30 or greater, or 27 or greater in persons with coexisting conditions. 7,8Īlthough lifestyle intervention (diet and exercise) represents the cornerstone of weight management, 1,2 sustaining weight loss over the long term is challenging. 6 More recently, obesity has been linked to increased numbers of hospitalizations, the need for mechanical ventilation, and death in persons with coronavirus disease 2019 (Covid-19). 1-3 Obesity can lead to insulin resistance, hypertension, and dyslipidemia, 4 is associated with complications such as type 2 diabetes, cardiovascular disease, and nonalcoholic fatty liver disease, 2,5 and reduces life expectancy. Obesity is a chronic disease and global public health challenge. Weekly Semaglutide in Adults with Overweight or Obesity (Funded by Novo Nordisk STEP 1 number, NCT03548935). In participants with overweight or obesity, 2.4 mg of semaglutide once weekly plus lifestyle intervention was associated with sustained, clinically relevant reduction in body weight. More participants in the semaglutide group than in the placebo group discontinued treatment owing to gastrointestinal events (59 vs. Nausea and diarrhea were the most common adverse events with semaglutide they were typically transient and mild-to-moderate in severity and subsided with time. Participants who received semaglutide had a greater improvement with respect to cardiometabolic risk factors and a greater increase in participant-reported physical functioning from baseline than those who received placebo. The change in body weight from baseline to week 68 was −15.3 kg in the semaglutide group as compared with −2.6 kg in the placebo group (estimated treatment difference, −12.7 kg 95% CI, −13.7 to −11.7). 28 ) at week 68 (P<0.001 for all three comparisons of odds). More participants in the semaglutide group than in the placebo group achieved weight reductions of 5% or more (1047 participants vs. The mean change in body weight from baseline to week 68 was −14.9% in the semaglutide group as compared with −2.4% with placebo, for an estimated treatment difference of −12.4 percentage points (95% confidence interval, −13.4 to −11.5 P<0.001). The primary estimand (a precise description of the treatment effect reflecting the objective of the clinical trial) assessed effects regardless of treatment discontinuation or rescue interventions. The coprimary end points were the percentage change in body weight and weight reduction of at least 5%. In this double-blind trial, we enrolled 1961 adults with a body-mass index (the weight in kilograms divided by the square of the height in meters) of 30 or greater (≥27 in persons with ≥1 weight-related coexisting condition), who did not have diabetes, and randomly assigned them, in a 2:1 ratio, to 68 weeks of treatment with once-weekly subcutaneous semaglutide (at a dose of 2.4 mg) or placebo, plus lifestyle intervention. Whether adults with obesity can achieve weight loss with once-weekly semaglutide at a dose of 2.4 mg as an adjunct to lifestyle intervention has not been confirmed. ![]() Obesity is a global health challenge with few pharmacologic options. The most trusted, influential source of new medical knowledge and clinical best practices in the world. Information and tools for librarians about site license offerings. ![]() Valuable tools for building a rewarding career in health care. The authorized source of trusted medical research and education for the Chinese-language medical community. The most advanced way to teach, practice, and assess clinical reasoning skills. Information, resources, and support needed to approach rotations - and life as a resident. The most effective and engaging way for clinicians to learn, improve their practice, and prepare for board exams. NEW! Peer-reviewed journal featuring in-depth articles to accelerate the transformation of health care delivery.Ĭoncise summaries and expert physician commentary that busy clinicians need to enhance patient care. NEW! A digital journal for innovative original research and fresh, bold ideas in clinical trial design and clinical decision-making.
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