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Semaglutide for the treatment of antipsychotic-associated weight gain in patients not responding to metformin – a case series

Metformin is the currently accepted first-line treatment for antipsychotic-associated weight gain (AAWG). However, not all patients benefit from metformin. Glucagon-like peptide-1 receptor agonists (GLP1-RA) have shown promise in the management of obesity in the general population, with preliminary...

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Autores principales: Prasad, Femin, De, Riddhita, Korann, Vittal, Chintoh, Araba F., Remington, Gary, Ebdrup, Bjørn H., Siskind, Dan, Knop, Filip Krag, Vilsbøll, Tina, Fink-Jensen, Anders, Hahn, Margaret K., Agarwal, Sri Mahavir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10126648/
https://www.ncbi.nlm.nih.gov/pubmed/37113745
http://dx.doi.org/10.1177/20451253231165169
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author Prasad, Femin
De, Riddhita
Korann, Vittal
Chintoh, Araba F.
Remington, Gary
Ebdrup, Bjørn H.
Siskind, Dan
Knop, Filip Krag
Vilsbøll, Tina
Fink-Jensen, Anders
Hahn, Margaret K.
Agarwal, Sri Mahavir
author_facet Prasad, Femin
De, Riddhita
Korann, Vittal
Chintoh, Araba F.
Remington, Gary
Ebdrup, Bjørn H.
Siskind, Dan
Knop, Filip Krag
Vilsbøll, Tina
Fink-Jensen, Anders
Hahn, Margaret K.
Agarwal, Sri Mahavir
author_sort Prasad, Femin
collection PubMed
description Metformin is the currently accepted first-line treatment for antipsychotic-associated weight gain (AAWG). However, not all patients benefit from metformin. Glucagon-like peptide-1 receptor agonists (GLP1-RA) have shown promise in the management of obesity in the general population, with preliminary evidence supporting efficacy in AAWG. Semaglutide is a weekly injectable GLP-1RA which received recent approval for obesity management and noted superiority over other GLP-1RAs. This study explored the efficacy and tolerability of semaglutide in AAWG among individuals with severe mental illness. A retrospective chart review of patients treated with semaglutide in the Metabolic Clinic at the Center for Addiction and Mental Health (CAMH) between 2019 and 2021 was conducted. Patients failing a trial of metformin (<5% weight loss or continuing to meet criteria for metabolic syndrome) after 3 months at the maximum tolerated dose (1500–2000 mg/day) were initiated on semaglutide up to 2 mg/week. The primary outcome measure was a change in weight at 3, 6, and 12 months. Twelve patients on weekly semaglutide injections of 0.71 ± 0.47 mg/week were included in the analysis. About 50% were female; the average age was 36.09 ± 13.32 years. At baseline, mean weight was 111.4 ± 31.7 kg, BMI was 36.7 ± 8.2 kg/m(2), with a mean waist circumference of 118.1 ± 19.3 cm. A weight loss of 4.56 ± 3.15 kg (p < 0.001), 5.16 ± 6.27 kg (p = 0.04) and 8.67 ± 9 kg (p = 0.04) was seen at 3, 6, and 12 months, respectively, after initiation of semaglutide with relatively well-tolerated side-effects. Initial evidence from our real-world clinical setting suggests that semaglutide may be effective in reducing AAWG in patients not responding to metformin. Randomized control trials investigating semaglutide for AAWG are needed to corroborate these findings.
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spelling pubmed-101266482023-04-26 Semaglutide for the treatment of antipsychotic-associated weight gain in patients not responding to metformin – a case series Prasad, Femin De, Riddhita Korann, Vittal Chintoh, Araba F. Remington, Gary Ebdrup, Bjørn H. Siskind, Dan Knop, Filip Krag Vilsbøll, Tina Fink-Jensen, Anders Hahn, Margaret K. Agarwal, Sri Mahavir Ther Adv Psychopharmacol Case Series Metformin is the currently accepted first-line treatment for antipsychotic-associated weight gain (AAWG). However, not all patients benefit from metformin. Glucagon-like peptide-1 receptor agonists (GLP1-RA) have shown promise in the management of obesity in the general population, with preliminary evidence supporting efficacy in AAWG. Semaglutide is a weekly injectable GLP-1RA which received recent approval for obesity management and noted superiority over other GLP-1RAs. This study explored the efficacy and tolerability of semaglutide in AAWG among individuals with severe mental illness. A retrospective chart review of patients treated with semaglutide in the Metabolic Clinic at the Center for Addiction and Mental Health (CAMH) between 2019 and 2021 was conducted. Patients failing a trial of metformin (<5% weight loss or continuing to meet criteria for metabolic syndrome) after 3 months at the maximum tolerated dose (1500–2000 mg/day) were initiated on semaglutide up to 2 mg/week. The primary outcome measure was a change in weight at 3, 6, and 12 months. Twelve patients on weekly semaglutide injections of 0.71 ± 0.47 mg/week were included in the analysis. About 50% were female; the average age was 36.09 ± 13.32 years. At baseline, mean weight was 111.4 ± 31.7 kg, BMI was 36.7 ± 8.2 kg/m(2), with a mean waist circumference of 118.1 ± 19.3 cm. A weight loss of 4.56 ± 3.15 kg (p < 0.001), 5.16 ± 6.27 kg (p = 0.04) and 8.67 ± 9 kg (p = 0.04) was seen at 3, 6, and 12 months, respectively, after initiation of semaglutide with relatively well-tolerated side-effects. Initial evidence from our real-world clinical setting suggests that semaglutide may be effective in reducing AAWG in patients not responding to metformin. Randomized control trials investigating semaglutide for AAWG are needed to corroborate these findings. SAGE Publications 2023-04-19 /pmc/articles/PMC10126648/ /pubmed/37113745 http://dx.doi.org/10.1177/20451253231165169 Text en © The Author(s), 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Series
Prasad, Femin
De, Riddhita
Korann, Vittal
Chintoh, Araba F.
Remington, Gary
Ebdrup, Bjørn H.
Siskind, Dan
Knop, Filip Krag
Vilsbøll, Tina
Fink-Jensen, Anders
Hahn, Margaret K.
Agarwal, Sri Mahavir
Semaglutide for the treatment of antipsychotic-associated weight gain in patients not responding to metformin – a case series
title Semaglutide for the treatment of antipsychotic-associated weight gain in patients not responding to metformin – a case series
title_full Semaglutide for the treatment of antipsychotic-associated weight gain in patients not responding to metformin – a case series
title_fullStr Semaglutide for the treatment of antipsychotic-associated weight gain in patients not responding to metformin – a case series
title_full_unstemmed Semaglutide for the treatment of antipsychotic-associated weight gain in patients not responding to metformin – a case series
title_short Semaglutide for the treatment of antipsychotic-associated weight gain in patients not responding to metformin – a case series
title_sort semaglutide for the treatment of antipsychotic-associated weight gain in patients not responding to metformin – a case series
topic Case Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10126648/
https://www.ncbi.nlm.nih.gov/pubmed/37113745
http://dx.doi.org/10.1177/20451253231165169
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