Introduction: Data from randomized controlled trials show that liraglutide 3.0 mg, in combination with diet and exercise, is associated with greater weight loss than diet and exercise alone in patients with obesity. In practice, the utilization of weight loss drugs is influenced by various factors, including the cost of treatment. We conducted a retrospective, observational study to assess the effectiveness of liraglutide 3.0 mg and patients’ persistence on treatment, in a real-world setting. Methods: Data were extracted from de-identified electronic medical records from an obesity management clinic in Switzerland. Changes in body weight and blood pressure were evaluated in the full cohort (N = 277, 19% of whom had undergone bariatric surgery) and subgroups who were persistent on liraglutide 3.0 mg for at least 4 months (n = 236), 7 months (n = 159), or 12 months (n = 71). Results: Median persistence on liraglutide was 6.8 months. Median maximum dose received was 1.5 mg, and 13.7% of patients reached the maintenance dose of 3.0 mg. Mean 7-month weight change from baseline in the full cohort was −4.1 kg (95% confidence interval: −5.0, −3.2; p #x3c; 0.001; −4.2%). Weight change was −4.4 kg (−4.7%) in the ≥4-month persistence subgroup at 4 months, −5.1 kg (−5.3%) in the ≥7-month persistence subgroup at 7 months, and −7.5 kg (−7.1%) in the ≥12-month persistence subgroup at 12 months (all p #x3c; 0.001). In the full cohort, 40% and 14% of patients lost ≥5% and #x3e;10% of body weight at 7 months, respectively. Weight loss did not differ significantly according to history of bariatric surgery (p = 0.94). Diastolic blood pressure decreased (from 87.0 to 83.9 mm Hg at 7 months; p = 0.018), with no significant changes in systolic blood pressure. Approximately two-thirds of patients did not have health insurance that could cover the cost of liraglutide. Conclusion: In a real-world setting with low insurance coverage and with most patients not reaching the recommended maintenance dose of 3.0 mg, the use of liraglutide, in combination with diet and exercise, was associated with clinically meaningful weight loss.
Obes Facts

中文翻译：

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在瑞士的真实环境中使用利拉鲁肽 3.0 mg 进行体重管理

简介：来自随机对照试验的数据表明，在肥胖患者中，利拉鲁肽 3.0 mg 联合饮食和运动与单独饮食和运动相比，体重减轻幅度更大。在实践中，减肥药的使用受到多种因素的影响，包括治疗费用。我们进行了一项回顾性观察性研究，以评估利拉鲁肽 3.0 mg 的有效性和患者在真实环境中的治疗持续性。方法：数据是从瑞士一家肥胖管理诊所的去识别化电子病历中提取的。在整个队列中评估体重和血压的变化（ N= 277，其中 19% 接受过减肥手术）和持续使用利拉鲁肽 3.0 mg 至少 4 个月（n = 236）、7 个月（n = 159）或 12 个月（n = 71）的亚组。结果：利拉鲁肽的中位持续时间为 6.8 个月。接受的中位最大剂量为 1.5 mg，13.7% 的患者达到了 3.0 mg 的维持剂量。整个队列中 7 个月自基线的平均体重变化为 -4.1 kg（95% 置信区间：-5.0、-3.2；p #x3c；0.001；-4.2%）。≥4 个月持续性亚组在 4 个月时的体重变化为 -4.4 kg (-4.7%)，在 7 个月时≥7 个月持续性亚组的体重变化为 -5.1 kg (-5.3%) 和 -7.5 kg (-7.1 %) 在 12 个月时≥12 个月的持续性亚组中（所有p #x3c; 0.001）。在整个队列中，40% 和 14% 的患者在 7 个月时分别减少了≥5% 和 #x3e；10% 的体重。根据减肥手术史，体重减轻没有显着差异（p = 0.94）。舒张压降低（从 7 个月时的 87.0 毫米汞柱降至 83.9 毫米汞柱；p = 0.018），收缩压没有显着变化。大约三分之二的患者没有可以支付利拉鲁肽费用的健康保险。结论：在保险覆盖率较低且大多数患者未达到 3.0 mg 的推荐维持剂量的现实环境中，利拉鲁肽联合饮食和运动的使用与具有临床意义的体重减轻相关。
肥胖事实