Health Technology Brief

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Liraglutide (Saxenda) For Weight Loss in Nondiabetic Obese Adults

March 29, 2018

Health Problem: The prevalence of obesity remains high in the United States. Recent estimates indicate that more than one-third of adults have obesity. Obesity is a serious health concern because it adversely affects mental health and quality of life, and is associated with leading causes of death, including diabetes, heart disease, stroke and some types of cancer.

Technology Description: Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist. GLP-1 receptor agonists are a class of drugs that mimic the effects of the naturally occurring gut hormone GLP-1. The GLP-1 hormone, which is released in the gastrointestinal tract after a meal, stimulates insulin secretion, inhibits glucagon release, delays gastric emptying, reduces food intake, and normalizes fasting and postprandial insulin secretion. GLP-1 receptor agonists have similar, but more enduring, effects to the naturally occurring hormone.

Controversy: Use of GLP-1 receptor agonists could potentially cause serious adverse events (AEs). While the most frequently occurring AEs associated with GLP-1 receptor agonists include mild-to-moderate gastrointestinal discomfort (e.g., nausea, diarrhea, and vomiting), the Food and Drug Administration has issued a black box warning for liraglutide concerning the potential risk of thyroid C-cell tumors. The FDA also warns that liraglutide is contraindicated in patients with a personal or family history of medullary thyroid carcinoma and in patients with multiple endocrine neoplasia syndrome type 2.

Key Questions:

  • Is liraglutide effective in treating obesity in nondiabetic adults?
  • How does liraglutide compare with placebo or other weight loss therapies?
  • Is liraglutide safe?
  • Have definitive patient selection criteria been identified for liraglutide?