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Efficacy of High-Dose Liraglutide as an Adjunct for Weight Loss in Patients with Prior Bariatric Surgery

Abstract

Background

Bariatric surgery is the most effective long-term treatment of severe obesity. Unfortunately, many patients experience inadequate weight loss, weight plateau, or weight recidivism. We sought to determine the efficacy of high-dose liraglutide (3.0 mg once daily) in patients with prior bariatric surgery.

Methods

We performed a retrospective chart review of 33 consecutive patients, aged 18–65, who received liraglutide for weight loss in the setting of any previous bariatric surgery. Indications were weight recidivism (> 10% weight regain from lowest post-surgical weight), inadequate weight loss (< 20% weight loss from initial clinic assessment, or pre-surgical weight if unavailable), and plateau (patient desires further weight loss but does not fit into either other category). Our primary outcomes were median percentage weight loss and median BMI change at 16 and 28 weeks, inclusive of time taken to titrate the medication to target dose. Secondary outcomes were the presence of adverse effects and the need to discontinue the medication.

Results

Of a total of 33 patients identified, 20 met inclusion criteria and had adequate data to be included in our analysis. At 16 weeks median percentage weight loss was 7.1% (IQR 5.1–12.2%), and at 28 weeks 9.7% (IQR 7.8–13.9%). Median BMI change was 3.5 kg/m2 (16 weeks, IQR 2.2–4.6 kg/m2) and 4.7 kg/m2 (28 weeks, IQR 3.7−5.6 kg/m2). There were no major adverse events.

Conclusions

High-dose liraglutide is an effective adjunct treatment for weight loss in patients with prior bariatric surgery.

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Correspondence to Peter Rye.

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Conflict of Interest

Author 1: The author declares no conflict of interest.

Author 2: Novo Nordisk Canada (travel and speaker fees), Shire Pharma Canada (development of educational materials, speaker fees), and Valeant Canada (travel and speaker fees).

Author 3: Novo Nordisk Canada (travel, speaker, and consultant fees), and Valeant (consultant fees).

Author 4: Novo Nordisk (travel, speaker, consultant fees, and advisory board), Merck (travel, speaker, and consultant fees), and Valeant (advisory board).

Ethics and Consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent was obtained from all individual participants included in the study.

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Rye, P., Modi, R., Cawsey, S. et al. Efficacy of High-Dose Liraglutide as an Adjunct for Weight Loss in Patients with Prior Bariatric Surgery. OBES SURG 28, 3553–3558 (2018). https://doi.org/10.1007/s11695-018-3393-7

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  • DOI: https://doi.org/10.1007/s11695-018-3393-7

Keywords

  • Bariatric surgery
  • Roux-en-Y gastric bypass
  • Sleeve gastrectomy
  • Liraglutide
  • Obesity
  • Adjustable gastric band