Key result
Adjunctive daily liraglutide after conversional Roux-en-Y Gastric Bypass significantly increased total weight loss at 12 months compared to placebo (24.15% vs 22.70%; P<0.001).
Why the study?
Conversional bariatric surgery inherently produces less weight loss than primary procedures, and adjunctive liraglutide after conversional Roux-en-Y Gastric Bypass may maximize weight loss benefits.
Does liraglutide improve weight loss in patients undergoing conversional Roux-en-Y Gastric Bypass?
RCT (n=80)
Double-blind
randomized
No
Does liraglutide improve weight loss in patients undergoing conversional Roux-en-Y Gastric Bypass?
Absolute Event Rate: 24.15% vs 22.7%
p-value: p=<0.001
Adjunctive use of liraglutide after conversional Roux-en-Y Gastric Bypass significantly improves weight loss compared to placebo.
Adjunctive liraglutide after cRYGB augments weight loss; extends RCT evidence for GLP-1 agonists in conversional bariatric surgery.
BACKGROUND: Conversional bariatric surgery inherently has less weight loss (WL) compared to primary procedures. Adjunctive use of the GLP-1 analog, liraglutide with conversional Roux-en-Y Gastric Bypass (cRYGB) may maximize the WL benefits of surgery. MATERIAL AND METHODS: This single-center randomized double-blind placebo-controlled trial included 80 patients randomized into two groups; the liraglutide group (40 patients) who received daily injections of liraglutide, and the placebo group (40 patients) who received normal saline starting at 6 weeks from cRYGB and continued for 6 months. After discontinuing the drugs at 6 months and unblinding, the patient were followed up to 12 months. The endpoints were percentage of total weight loss (%TWL) and percentage of excess weight loss (%EWL), and changes in the metabolic biomarkers, and complications within 30 and 90 days according to the global outcome benchmark (GOB) stratification. RESULTS: In total, 38 patients in the liraglutide group and 31 in the placebo group completed the 24 weeks. Liraglutide group experienced better WL with a significantly higher mean %TWL at 1 month (10.27±1.39 vs. 8.41±2.08), at 6 weeks (12.65±1.77 vs. 10.47±2.23), at 6 months (18.29 ±1.74 vs. 15.58 ±1.65), and at 12 months 24.15±2.35 versus 22.70±2.13 (all P <0.001). For %EWL, this was also significantly higher in the liraglutide group at all time points. A %TWL of greater than 20% at 6 months of treatment was recorded in six (15.8%) patients in the liraglutide group and none in the placebo group ( P =0.029). Both groups had comparable changes in metabolic biomarkers. Adverse events were recorded in 11 (27.5%) patients in the liraglutide, with no adverse events in the placebo group ( P <0.001). Both groups had Clavien-Dindo scores I and II (5.0 and 2.5%), and GOB values indicated that 90.0 and 97.5% were low-risk patients. CONCLUSION: Adjunctive use of liraglutide with cRYGB gives significantly higher WL and resolution of associated medical problems.
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Hany et al. (2023) conducted an RCT in Conversional Roux-en-Y Gastric Bypass (n=80). Liraglutide vs. Placebo (normal saline) was evaluated on percentage of total weight loss (%TWL) at 12 months (p=<0.001). Adjunctive daily liraglutide after conversional Roux-en-Y Gastric Bypass significantly increased total weight loss at 12 months compared to placebo (24.15% vs 22.70%; P<0.001).
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