Glucagon-Like Peptide-1 Receptor Agonist Use and Residual Gastric Content Before Anesthesia

JAMA Surgery, Journal Year: 2024, Volume and Issue: 159(6), P. 660 - 660

Published: March 6, 2024

Glucagon-like peptide-1 receptor agonist (GLP-1 RA) use is rapidly increasing in the US, driven by its expanded approval for weight management addition to hyperglycemia patients with type 2 diabetes. The perioperative safety of these medications, particularly aspiration risk under anesthesia, uncertain.

Language: Английский

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Obesity in adults

The Lancet, Journal Year: 2024, Volume and Issue: 404(10456), P. 972 - 987

Published: Aug. 16, 2024

Language: Английский

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The Role of Lifestyle Modification with Second-Generation Anti-obesity Medications: Comparisons, Questions, and Clinical Opportunities

Current Obesity Reports, Journal Year: 2023, Volume and Issue: 12(4), P. 453 - 473

Published: Dec. 2, 2023

Abstract Purpose of Review This review examines lifestyle modification for obesity management with the goal identifying treatment components that could support use a new generation anti-obesity medications (AOMs). Recent Findings Semaglutide reliably reduces baseline body weight by approximately 15% at 68 weeks, in contrast to 5–10% modification. Tirzepatide induces mean losses as great 20.9%. Both reduce energy intake markedly enhancing satiation and decreasing hunger, they appear lessen need traditional cognitive behavioral strategies (e.g., monitoring food intake) achieve calorie restriction. Little, however, is known about whether patients who lose these AOMs adopt healthy diet activity patterns needed optimize composition, cardiometabolic health, quality life. Summary When used AOMs, focus likely change from inducing loss (through restriction) facilitating patients’ adoption dietary will promote optimal changes composition overall health.

Language: Английский

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Trends in glucagon-like peptide 1 receptor agonist use, 2014 to 2022

Journal of the American Pharmacists Association, Journal Year: 2023, Volume and Issue: 64(1), P. 133 - 138

Published: Oct. 10, 2023

Abstract

Background

Recent Food and Drug Administration approvals of glucagon-like peptide 1 (GLP-1) receptor agonists linked to substantial weight loss have generated interest in demand projections. However, a longitudinal analysis large, diverse, current, real-world database has not been published.

Objectives

The study objective was determine user frequency GLP-1 agonist products overall by type 2 diabetes (T2D), cardiovascular disease (CVD), overweight or obese status. Secondary monthly growth rate estimation product since first appearance University California Health.

Methods

This retrospective cohort included patients who were dispensed from 2014 2022 the Health Data Warehouse. Exponential rates estimated using log-linear regression model.

Results

Between 2018, only Trulicity Victoza exceeded 5000 annual users. Ozempic users increased 569 2019 7667 2020. Use accelerated with more than 13,310 2021 surpass Trulicity. count 22,891 2022. Wegovy rose 989 2992 Mounjaro 1508 Although generally similar trends observed for T2D, CVD, subgroups, ascent as most frequently used apparent group. 83.9% Ozempic, 119.2% Wegovy, 84.8% Rybelsus, 53.3% Saxenda, 12.9% Adlyxin, 78.8% Trulicity, 254.3% Mounjaro.

Conclusion

loss–associated state-wide health system demonstrated rapid use that represents clear likely durable transition utilization this category. Informed decision making studies are needed ensure evidence-concordant prescribing supply stability.

Language: Английский

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National-level and state-level prevalence of overweight and obesity among children, adolescents, and adults in the USA, 1990–2021, and forecasts up to 2050

The Lancet, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 1, 2024

Over the past several decades, overweight and obesity epidemic in USA has resulted a significant health economic burden. Understanding current trends future trajectories at both national state levels is crucial for assessing success of existing interventions informing policy changes. We estimated prevalence from 1990 to 2021 with forecasts 2050 children adolescents (aged 5-24 years) adults ≥25 level. Additionally, we derived state-specific estimates projections older 15-24 all 50 states Washington, DC.

Language: Английский

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Semaglutide vs Endoscopic Sleeve Gastroplasty for Weight Loss

JAMA Network Open, Journal Year: 2024, Volume and Issue: 7(4), P. e246221 - e246221

Published: April 12, 2024

Importance Obesity is a disease with large socioeconomic burden. Endoscopic sleeve gastroplasty (ESG) minimally invasive endoscopic bariatric procedure wide global adoption. More recently, new weight-loss medications, such as glucagon-like peptide-1 receptor agonists (eg, semaglutide), have attracted increased attention due to their efficacy. However, cost-effectiveness over an extended period compared ESG critical gap that needs be better explored for informed health care decision-making. Objective To assess the of semaglutide 5 years individuals class II obesity. Design, Setting, and Participants This economic evaluation study, conducted from September 1, 2022, May 31, 2023, used Markov cohort model compare semaglutide, no-treatment baseline strategy. The study comprised adult patients in US system obesity (body mass index [BMI] 35-39.9). base case was 45-year-old patient (BMI 37). Patients undergoing were subjected risks perioperative mortality adverse events resultant costs decrement quality life. Interventions Strategies included treatment ESG. Main Outcomes Measures Costs (2022 dollars), quality-adjusted life-years (QALYs), incremental ratio (ICER) willingness-to-pay threshold $100 000/QALY. A 5-year time horizon cycle length 1 month 3% discount rate used. Probabilities, costs, quality-of-life estimates derived published literature. One-way, 2-way, probabilistic sensitivity analyses also performed. Results found more cost-effective than horizon, ICER –$595 532/QALY. added 0.06 QALYs reduced total cost by $33 583 relative semaglutide. results remained robust on 1-way analyses. sustained greater weight loss vs 31.7 33.0). achieve nondominance, annual price currently $13 618, would need $3591. Conclusions Relevance suggests saving On analyses, 3-fold decrease needed nondominance.

Language: Английский

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Effectiveness and safety of drugs for obesity

BMJ, Journal Year: 2024, Volume and Issue: unknown, P. e072686 - e072686

Published: March 25, 2024

Abstract Recent publicity around the use of new antiobesity medications (AOMs) has focused attention patients and healthcare providers on role pharmacotherapy in treatment obesity. Newer drug treatments have shown greater efficacy safety compared with older treatments, yet access to these is limited by providers’ discomfort prescribing, bias, stigma obesity, as well lack insurance coverage. Now more than ever, must be able discuss risks benefits full range available patients, incorporate both guideline based advice emerging real world clinical evidence into daily practice. The tremendous variability response means that clinicians need a flexible approach takes advantage specific features medication selected provide best option for individual patients. Future research needed how practice settings, potential combination therapies, cost effectiveness medications. Several are being evaluated ongoing trials, suggesting future obesity bright.

Language: Английский

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Discontinuation and Reinitiation of Dual-Labeled GLP-1 Receptor Agonists Among US Adults With Overweight or Obesity

JAMA Network Open, Journal Year: 2025, Volume and Issue: 8(1), P. e2457349 - e2457349

Published: Jan. 31, 2025

Importance Adherence to glucagon-like peptide-1 receptor agonists (GLP-1 RAs) is important for their effectiveness. Discontinuation and reinitiation patterns are not well understood. Objective To describe rates of factors associated with discontinuation subsequent GLP-1 RAs among adults overweight or obesity. Design, Setting, Participants In this retrospective cohort study, 125 474 obesity newly initiated treatment a dual-labeled RA (liraglutide, semaglutide, tirzepatide) between January 1, 2018, December 31, 2023, baseline body mass index 27 more, an available weight measurement within 60 days before initiation, regular care in the year initiation were identified using electronic health record data from collective US systems. Patients followed up 2 years assess additional reinitiation. Exposure stratified by presence type diabetes at baseline. Main Outcomes Measures Proportions patients discontinuing reinitiating estimated Kaplan-Meier models. Associations sociodemographic characteristics, factors, changes, gastrointestinal adverse events outcomes modeled time-varying Cox proportional hazards regression All analyses conducted separately without diabetes. Results study (mean [SD] age, 54.4 [13.1] years; 82 063 women [65.4%]), 76 524 (61.0%) had One-year was significantly higher (64.8% [95% CI, 64.4%-65.2%]) compared those (46.5% 46.2%-46.9%]). Higher loss (1% reduction 3.1% 2.9%-3.2%] lower hazard 3.3% 3.2%-3.5%] diabetes) income (type only; >$80 000: ratio [HR], 0.72 0.69-0.76]) discontinuation, while moderate severe incident (with diabetes: HR, 1.38 1.31-1.45]; 1.19 1.12-1.27]). Of 41 792 who discontinued available, 1-year (36.3% 35.6%-37.0%]) (47.3% 46.6%-48.0%]). Weight regain 1% increased 2.3% (95% 1.9%-2.8%) 2.8% 2.4%-3.2%) Conclusions Relevance most therapy 1 year, but rates. Inequities access adherence effective treatments have potential exacerbate disparities

Language: Английский

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Patents and Regulatory Exclusivities on GLP-1 Receptor Agonists

JAMA, Journal Year: 2023, Volume and Issue: 330(7), P. 650 - 650

Published: July 28, 2023

Glucagon-like peptide 1 (GLP-1) receptor agonists were first approved for the treatment of type 2 diabetes in 2005. Demand these drugs has increased rapidly recent years, as indications have expanded, but they remain expensive.

Language: Английский

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State Coverage and Reimbursement of Antiobesity Medications in Medicaid

JAMA, Journal Year: 2024, Volume and Issue: 331(14), P. 1230 - 1230

Published: March 14, 2024

This study examines state Medicaid coverage policies for antiobesity medications and their trends in reimbursement from 2011 to 2022.

Language: Английский

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