Medscape: Injectable liraglutide plus lifestyle changes reduce visceral fat in overweight, obese adults
UC expert says research could help guide doctors in treatment decisions
New research shows that in overweight and obese adults at high cardiovascular risk, once-daily subcutaneous liraglutide plus changes in diet and physical activity reduced visceral fat.
The study authors note, "The relative effects of liraglutide on fat reduction were two times greater in the abdominal viscera and six times greater in the liver than seen on overall bodyweight."
In an article on the research published by Medscape, Vincent Fong, MD, PhD, in the Division of Endocrinology, Diabetes and Metabolism in the Department of Internal Medicine at the UC College of Medicine was quoted reacting to the findings.
"We have known for some time that visceral and ectopic fat were much more associated with metabolic dysfunction when compared to subcutaneous fat, and that liraglutide has shown ability to reduce both in previous studies in patients with diabetes. There are some data that other medications of the same class (GLP1 receptor agonists) also have similar effects."
"What is good about this study is that it was a prospective randomized controlled trial with a relatively large sample size and detailed measurements of different fat depots," he said. "What is new is that none of the participants had diabetes, and most did not even have prediabetes."
"So, as a physician, if that was a distinction that you used to decide whether or not to prescribe liraglutide, then this study would make a very big difference in your practice," Fong told Medscape. "If not, then it is still helpful in that it is provided high quality data supporting its benefits reducing metabolically active fat, but maybe does not drastically change prescribing practices."
However, he noted that "in reality, liraglutide is very cost-prohibitive and that is a much larger factor in prescribing decisions." Very few payors cover the 3 mg dose, which is indicated for obesity, and was the dosage used in the study, he said. "It would be very difficult for most people to afford the treatment, so if cost doesn't change, then it doesn't matter what the benefit is if patients can't afford it."
"Similar studies using medications of the same class are needed to prove whether this is a class effect, as many believe, versus a liraglutide-specific benefit," he added.
"It is my opinion that it is likely a class effect, so in agreement with ADA Standards of Care for treatment of diabetes, GLP1 receptor agonist medications should be considered early in patients with established cardiovascular disease or high risk of cardiovascular disease," Fong concluded.
Fong was also quoted in a story published by Everyday Health on a study showing that insulin resistance being tied to a twofold risk of depression. See that coverage here.
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