בפוסט זה – @ יואל קסלר . קום- אנו מציגים נתונים שפורסמו לאחרונה המראים כי מטופלים רבים חוזרים במשקל שירד בשימוש בטירספטיד למשך 36 שבועות, לאחר הפסקת הטיפול.
In this post – Maintenance of weight reduction after discontinuation of GLP 1 receptor antagonists @ יואל קסלר- we present recently published data from JAMA Network that shows that many patients regain weight that was lost with use of tirzepatide for 36 weeks, after its discontinuation.
Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With ObesityThe SURMOUNT-4 Randomized Clinical Trial
Louis J. Aronne, MD1; Naveed Sattar, MD2; Deborah B. Horn, DO, MPH3; et alHarold E. Bays, MD4; Sean Wharton, MD5; Wen-Yuan Lin, MD, PhD6; Nadia N. Ahmad, MD, MPH7; Shuyu Zhang, MSc7; Ran Liao, PhD7; Mathijs C. Bunck, MD, PhD7; Irina Jouravskaya, MD, PhD8; Madhumita A. Murphy, MD7; for the SURMOUNT-4 Investigators
Author Affiliations Article Information
JAMA. Published online December 11, 2023. doi:10.1001/jama.2023.24945
Question Does once-weekly subcutaneous tirzepatide with diet and physical activity affect maintenance of body weight reduction in individuals with obesity or overweight?
Findings After 36 weeks of open-label maximum tolerated dose of tirzepatide (10 or 15 mg), adults (n = 670) with obesity or overweight (without diabetes) experienced a mean weight reduction of 20.9%. From randomization (at week 36), those switched to placebo experienced a 14% weight regain and those continuing tirzepatide experienced an additional 5.5% weight reduction during the 52-week double-blind period.
Meaning In participants with obesity/overweight, withdrawing tirzepatide led to substantial regain of lost weight, whereas continued treatment maintained and augmented initial weight reduction.
Abstract
Importance The effect of continued treatment with tirzepatide on maintaining initial weight reduction is unknown.
Objective To assess the effect of tirzepatide, with diet and physical activity, on the maintenance of weight reduction.
Design, Setting, and Participants This phase 3, randomized withdrawal clinical trial conducted at 70 sites in 4 countries with a 36-week, open-label tirzepatide lead-in period followed by a 52-week, double-blind, placebo-controlled period included adults with a body mass index greater than or equal to 30 or greater than or equal to 27 and a weight-related complication, excluding diabetes.
Interventions Participants (n = 783) enrolled in an open-label lead-in period received once-weekly subcutaneous maximum tolerated dose (10 or 15 mg) of tirzepatide for 36 weeks. At week 36, a total of 670 participants were randomized (1:1) to continue receiving tirzepatide (n = 335) or switch to placebo (n = 335) for 52 weeks.
Main Outcomes and Measures The primary end point was the mean percent change in weight from week 36 (randomization) to week 88. Key secondary end points included the proportion of participants at week 88 who maintained at least 80% of the weight loss during the lead-in period.
Results Participants (n = 670; mean age, 48 years; 473 [71%] women; mean weight, 107.3 kg) who completed the 36-week lead-in period experienced a mean weight reduction of 20.9%. The mean percent weight change from week 36 to week 88 was −5.5% with tirzepatide vs 14.0% with placebo (difference, −19.4% [95% CI, −21.2% to −17.7%]; P < .001). Overall, 300 participants (89.5%) receiving tirzepatide at 88 weeks maintained at least 80% of the weight loss during the lead-in period compared with 16.6% receiving placebo (P < .001). The overall mean weight reduction from week 0 to 88 was 25.3% for tirzepatide and 9.9% for placebo. The most common adverse events were mostly mild to moderate gastrointestinal events, which occurred more commonly with tirzepatide vs placebo.
Conclusions and Relevance In participants with obesity or overweight, withdrawing tirzepatide led to substantial regain of lost weight, whereas continued treatment maintained and augmented initial weight reduction.
Trial Registration ClinicalTrials.gov Identifier: NCT04660643
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