Effect of Polyethylene Glycol Loxenatide Treatment on Body Weight in Patients With Type 2 Diabetes With Different Body Mass Index: A Retrospective Real‐World Study

Introduction Real‐world data on the effect of polyethylene glycol loxenatide (PEG‐Loxe) in patients with Type 2 diabetes mellitus (T2DM) with normal body mass index (BMI) are lacking. Therefore, this study aims to observe the effect of PEG‐Loxe on the weight of patients with T2DM with different BMIs. Methods This single‐center, retrospective real‐world study included patients with T2DM, aged ≥ 18 years, and receiving PEG‐Loxe/sodium‐glucose cotransporter 2 inhibitor (SGLT2i). The primary endpoint was change in body weight after 24 weeks of treatment. Secondary endpoints included proportion of patients with body weight reduction < 5.0% and < 10%, changes in BMI, and glycosylated hemoglobin (HbA1c). Results Overall, 487 patients treated with SGLT2i or PEG‐Loxe were identified; after propensity score matching, 68 patients were included in each group. After 24 weeks, the mean change in body weight and BMI was −1.2 (−2.3, −0.1) and −0.4 (−0.8, −0.1) in the PEG‐Loxe group and −2.4 (−3.5, −1.3) and ‐0.7 (−1.1, −0.4) in the SGLT2i group. A ≥ 5% and ≥ 10% weight loss was noted by 32.4% and 8.8% of patients in the PEG‐Loxe group, with a mean change in HbA1c (%) of −1.48 (−1.98, −0.99). Weight loss (≥ 5%) in obese patients (BMI > 28 kg/m 2 ) was greater (PEG‐Loxe: 53.3%, SGLT2i: 57.1%) compared to patients with 24 ≤ BMI < 28 kg/m 2 (PEG‐Loxe: 25.7%, SGLT2i: 41.4%) and BMI < 24 kg/m 2 (PEG‐Loxe: 27.8%, SGLT2i: 28%). Conclusion PEG‐Loxe resulted in weight loss and glycemic control in patients with T2DM. The weight loss was negatively correlated with baseline BMI without excessive weight loss in normal BMI, supporting PEG‐Loxe’s use in this group. Trial Registration: Chinese Registry of Clinical Trials: ChiCTR2400087532