In the Journals Plus

Liraglutide slows gastric emptying to improve weight loss

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September 27, 2017

Michael Camilleri
Michael Camilleri

Adults with obesity treated with liraglutide experienced greater weight loss and a delay in gastric emptying compared with those assigned placebo, according to findings published in The Lancet Gastroenterology & Hepatology.

“In clinical practice, measurement of stomach emptying at 5 weeks may serve as a biomarker to determine which patients should continue on the treatment and which patients might be better candidates for other weight-loss treatments,” Michael Camilleri, MD, a gastroenterologist at the Mayo Clinic, said in a press release.

Camilleri and colleagues evaluated 40 adults with BMI of at least 30 kg/m2 randomly assigned to subcutaneous liraglutide 3 mg (Saxenda, Novo Nordisk; n = 19) or placebo (n = 21) for 16 weeks to determine change in gastric emptying of solids (time taken for half the radiolabeled meal to empty from the stomach) measured at 5 and 16 weeks. Secondary outcomes included weight loss at 5 and 16 weeks; volumes to satiation, satiety and fasting; and postprandial gastric volumes at 16 weeks.

Gastric emptying was delayed at 5 weeks with liraglutide (median, 70 minutes) compared with baseline (4 minutes; P < .0001). Gastric emptying continued to be delayed at 16 weeks with liraglutide (median, 30.5 minutes) compared with placebo (–1 minute; P = .025).

Participants assigned placebo had greater median weight loss compared with those assigned placebo at 5 weeks (3.7 kg vs. 0.6 kg; P < .0001) and 16 weeks (5.3 kg vs. 2.5 kg; P = .0009).

The maximum tolerated volume measure of satiation was lower in the liraglutide group than the placebo group at 16 weeks (median, 750 mL vs. 1,126 mL; P = .054).

No significant differences were observed for volume to fullness, satiety or fasting or postprandial gastric volumes at week 16 between the two groups.

“Liraglutide appears to be very effective in inducing weight loss over 3 months of treatment,” Camilleri told Endocrine Today. “Liraglutide dramatically slowed stomach emptying of solids and the degree of stomach emptying delay (for solids) in study participants was significantly associated with the degree of weight loss. Measurement of gastric emptying of solids after approximately 1 month of treatment could help to identify patients who would likely respond in the long-term to liraglutide with significant weight loss.”

In an accompanying editorial, Vincenzo Stanghellini, MD, professor in the department of medical and surgical science at the University of Bologna in Italy, wrote that the main strength of the study is that “gastric functions were measured as rigorously as possible using currently available techniques.”

“The clinical effect exerted on gastric emptying is important not only from a scientific viewpoint, but also for practical reasons, since measuring this gastric function after approximately 1 months of treatment could help to identify patients who would respond in the long term to liraglutide with significant weight loss, thus avoiding ineffective and expensive treatments in nonresponders,” he wrote. – by Amber Cox

For more information:

Michael Camilleri, MD , can be reached at newsbureau@mayo.edu.

Disclosures: Camilleri reports he receives grants from NIH, nonfinancial support from Novo Nordisk and research grants from Elira and Kallope. Stanghellini reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.