Use of liraglutide after bariatric surgery: a 36-month follow-up in a real-world setting in Chile

Farías, María Magdalena

doi:10.20945/2359-4292-2023-0234

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Original Article • Arch. Endocrinol. Metab. 68 • 2024 • https://doi.org/10.20945/2359-4292-2023-0234 linkcopy

Use of liraglutide after bariatric surgery: a 36-month follow-up in a real-world setting in Chile

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective: Bariatric surgery has several benefits, including sustainable weight loss and improvement or resolution of metabolic comorbidities. However, despite initially successful weight loss, weight regain occurs during long-term follow-up, and many patients are unable to reach or maintain their target weight goals. Liraglutide is a therapy for obesity aimed at preventing weight regain.

Materials and methods: This retrospective, observational, single-arm, pre-post study was performed to analyze the relative change in body weight among patients receiving liraglutide after bariatric surgery in a real-world setting in Chile.

Results: Treatment with liraglutide at a median dose of 1.2 mg was associated with a mean weight loss from baseline to 3, 6, 12, 24, and 36 months of 5%, 7.7%, 7.6%, 5.8%, and 5.1%, respectively. The mean body mass index reduction was 14.8% at 36 months. Dropout rates were consistent with those of usual obesity treatments. Overall, 70% of the patients were receiving other weight-loss drugs. Liraglutide was well tolerated, but cost barriers led to several patients interrupting its use.

Conclusion: Liraglutide is an effective and safe treatment for weight reduction after bariatric surgery in patients receiving routine clinical care in Chile.

Keywords
Liraglutide; bariatric surgery; obesity; Chile

Variable		All patients (n = 41)
Sex, n (%)
	Female	35 (85.3%)
	Male	6 (14.6%)
Surgery type, n (%)
	Roux-en-Y gastric bypass	5 (12.1%)
	Sleeve gastrectomy	36 (87.8%)
Presurgical characteristics
	Age, years (mean ± SD)	41.3 ± 11.5
	Body mass index, kg/m² (mean ± SD)	35.5 ± 4.6
Comorbidities, n (%)
	Hypertension	10 (24.3%)
	Diabetes mellitus	30 (73.1%)
	Nonalcoholic fatty liver disease	19 (46.3%)
	Dyslipidemia	15 (36.5%)
	Obstructive sleep apnea	4 (9.7%)
Postoperative nadir
	Body mass index, kg/m² (mean ± SD)*	25.2 ± 3.4
	Mean time to achieve nadir, months (median, range)†	12 (6 - 48)
	Excess of weight loss, % (median, range)*	102.3 (41.7 - 409.6)

Variable		All patients (n = 41)
Initial body mass index, kg/m² (median, range)		31 (23.9 - 45.3)
Initial weight, kg (median, range)		80.8 (61.4 - 127)
Time from surgery to medication start, months (median, range)		72 (12 - 228)
Liraglutide dose, mg (median, range)		1.2 (0.6 - 2.4)
Combination therapy, n (%)
	Phentermine	17 (41.4%)
	Metformin	12 (29.2%)
	Topiramate	4 (9.7%)
	Combination of any of these drugs	25 (60.9%)

	Total	Monotherapy	Combined treatment
3 months
Number of patients	41	16	25
BMI (mean ± SD)	29.1 ± 4 kg/m²	29.1 ± 3.7 kg/m²	29.2 ± 4.5 kg/m²
Weight loss from baseline	5.8%	4.8%	6.4%
Patients achieving weight loss > 5%	56%	37.5%	68%*
6 months
Number of patients	31	9	22
Dropout rate from previous visit (%)	24.4%	43.7%	12%†
BMI (mean ± SD)	27.9 ± 4 kg/m²	27.7 ± 4.2 kg/m²	28.0 ± 4.2 kg/m²
Weight loss from baseline	9%	8.4%	9.25%
Patients achieving weight loss > 10%	38.7%	33.3%	40.1%
12 months
Number of patients	20	4	16
Dropout rate from previous visit (%)	51.3%	75%	36%
BMI (mean ± SD)	25.9 ± 8 kg/m²	‡	26.9 ± 3.4 kg/m²
Weight loss from baseline	9.4%	‡	9.6%
Patients achieving weight loss > 10%	40%	‡	43.7%

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[TFN1] ^*
Data available for 38 patients.

[TFN1a] ^†
Data available for 22 patients. Abbreviation: SD, standard deviation.