Saxenda(liraglutide) joins the list of 4 new weight loss drugs approved by the US FDA since June of 2012 – Belviq(Lorcasering) and Qsymia(Phentermine and Topiramate) in 2012, and Contrave and Saxenda in 2014
How does Saxenda for weight loss work?
Saxenda(liraglutide) is a selective glucagon-like peptide-1 (GLP-1) receptor agonist type medication that was approved in December of 2014 in addition to diet and exercise for weight loss in those who are obese with a body mass index of 27 or more with a comborbid condition or those with a BMI of over 30. A lower dose of the same medication was approved in January 2010 as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus (T2DM) (tradename: Victoza). The maximum approved dose for the diabetes indication as Victoza is 1.8 mg daily, administered as a subcutaneous injection while the weight loss dose was 3.0 mg administered similarly.
How effective is Saxenda for weight loss?
In one clinical trial assessing the effectiveness and safety of Saxenda, patients had an average weight loss of 4.5 percent from baseline compared to treatment with a placebo (inactive pill) at one year. In this trial, 62 percent of patients treated with Saxenda lost at least 5 percent of their body weight compared with 34 percent of patients treated with placebo.
Saxenda trials in patients with diabetes for weight loss
In another clinical trial that enrolled patients with type 2 diabetes showed that patients had an average weight loss of 3.7 percent from baseline compared to treatment with placebo at one year. In this trial, 49 percent of patients treated with Saxenda lost at least 5 percent of their body weight compared with 16 percent of patients treated with placebo.
12 weeks of trial of Saxenda for weight loss
Just like any of the other new weight loss medications, patients taking Saxenda for weight loss should be evaluated after 16 weeks to determine if the treatment is working. It is recommended that if a patient has not lost at least 4 percent of baseline body weight, Saxenda should be discontinued, as it is unlikely that the patient will achieve and sustain clinically meaningful weight loss with continued treatment.
Better glycemic control
Although Saxenda is safe to take in non-diabetics, (in fact it is more effective for weight loss in non-diabetics than diabetics), the added benefit for prediabetics or diabetics is the fact that studies to date suggest liraglutide improves control of blood glucose. It reduces meal-related hyperglycemia (for 24 hours after administration) by increasing insulin secretion, delaying gastric emptying, and suppressing prandial glucagon secretion.
Benefits of Saxenda over other weight loss drugs!
- It acts in a glucose-dependent manner, meaning it will stimulate insulin secretion only when blood glucose levels are higher than normal. Consequently, it shows negligible risk of hypoglycemia.
- It has the potential for inhibiting apoptosis and stimulating regeneration of beta cells (seen in animal studies).
- It decreases appetite and maintains body weight, as shown in a head-to-head study versus glimepiride.
- It works in a novel mechanism instead of the usual stimulant(amphetamine based drugs)
- It lowers blood triglyceride levels.
Adverse effects of Saxenda
Saxenda has a boxed warning stating that tumors of the thyroid gland (thyroid C-cell tumors) have been observed in rodent studies with Saxenda but that it is unknown whether Saxenda causes thyroid C-cell tumors, including a type of thyroid cancer called medullary thyroid carcinoma (MTC), in humans. Saxenda should not be used in patients with a personal or family history of MTC or in patients with multiple endocrine neoplasia syndrome type 2 (a disease in which patients have tumors in more than one gland in their body, which predisposes them to MTC).
Serious side effects reported in patients treated with Saxenda include pancreatitis, gallbladder disease, renal impairment, and suicidal thoughts. Saxenda can also raise heart rate and should be discontinued in patients who experience a sustained increase in resting heart rate.
In 2013, a study conducted at UCLA reported a “marked expansion” of the pancreas in eight organ donors who had been treated with incretin mimetic drugs such as Victoza and Byetta. In response, the United States FDA and the European Medicines Agency conducted a review of all available data regarding the possible connection between incretin mimetics and pancreatitis or pancreatic cancer. In a joint letter to the New England Journal of Medicine, the agencies concluded that “A pooled analysis of data from 14,611 patients with type 2 diabetes from 25 clinical trials in the sitagliptin database provided no compelling evidence of an increased risk of pancreatitis or pancreatic cancer” and “Both agencies agree that assertions concerning a causal association between incretin-based drugs and pancreatitis or pancreatic cancer, as expressed recently in the scientific literature and in the media, are inconsistent with the current data. The FDA and the EMA have not reached a final conclusion at this time regarding such a causal relationship. Although the totality of the data that have been reviewed provides reassurance, pancreatitis will continue to be considered a risk associated with these drugs until more data are available; both agencies continue to investigate this safety signal.”
Thyroid cancer concerns
At exposures 8x greater than those used in humans, liraglutide caused a statistically significant increase in thyroid tumors in rats. In clinical trials, the rate of thyroid tumors in patients treated with liraglutide was 1.3 per 1000 patient years compared to 1.0 per 1000 patients in comparison groups. The label carries a boxed warning:
“ Because of the uncertain relevance of the rodent thyroid C-cell tumor findings to humans, prescribe Victoza only to patients for whom the potential benefits are considered to outweigh the potential risk. ”
The FDA said serum calcitonin, a biomarker of medulliary thyroid cancer, was slightly increased in liraglutide patients, but still within normal ranges, and it required ongoing monitoring for 15 years in a cancer registry.
Liraglutide is an acylated human glucagon-like peptide-1 (GLP-1) agonist, similar to human GLP-1(7-37), a less common form of endogenous GLP-1.
Liraglutide leads to insulin release in pancreatic beta cells in the presence of elevated blood glucose. This insulin secretion subsides as glucose concentrations decrease and approach euglycemia. It also decreases glucagon secretion in a glucose-dependent manner and delays gastric emptying. Unlike native GLP-1, liraglutide is stable against metabolic degradation by peptidases with a plasma half-life of 13 hours.
GLP-1, in its natural form, is short-lived in the body (the half-life after intramuscular injection is approximately half an hour), so it is not very useful as a therapeutic agent. However, liraglutide has a half-life after subcutaneous injection of 11–15 hours, making it suitable for once-daily dosing (less frequent than twice daily Byetta, but considerably more frequent than the once weekly Bydureon, which received approval from the FDA in January 2012).
GLP-1(7-37) has a half-life of 1.5–2 minutes due to degradation by the ubiquitous enzymes, dipeptidyl peptidase IV (DPP-IV) and neutral endopeptidases (NEP). The prolonged action of liraglutide is achieved by attaching a fatty acid molecule at one position of the GLP-1 molecule, enabling it to bind to albumin within the subcutaneous tissue and bloodstream. The active GLP-1 is then released from albumin at a slow, consistent rate. Albumin binding also results in slower degradation and reduced renal elimination compared to GLP-1.
Because of the unique mechanism of action and relative success on the market as Victoza at a lower dose for diabetes, Saxenda is expected to generate a lot of interest among the patients, prescribing physicians and the investors alike and is projected to break through the barriers faced by the other new weight loss medications including Qsymia, Belviq, and Contrave according to Dr. Prab R. Tumpati, MD, founder of W8MD medical weight loss centers and a leading weight loss expert with offices in 3 many states including New York, New Jersey and Pennsylvania.
Brand names for Saxenda
Liraglutide is marketed under the brandname Saxenda for weight loss and Victoza for diabetes in the U.S.
Other glucagon-like peptide-1 analogs:
- exenatide (Byetta)
W8MD Medical Weight Loss Centers of America is one of the first weight loss centers in America to start offering Saxenda to eligible patients to help fight the epidemic of obesity, and over 50 metabolic and health problems that are associated with obesity!
W8MD weight loss locations
King Of Prussia Weight Loss Center: 987 Old Eagle School Rd, Ste 712, Wayne, PA, 19087 Ph: 215-676-2334
Our farthest patient comes from Delaware! Testimonials
NYC Insurance Weight Loss Center: 2003, Bath Avenue, Brooklyn, NY, 11214 Ph: 1-718-946-5500.
Our farthest patient comes from Dallas, Texas! Testimonials
W8MD medical weight loss program at Vida Sleep Center of Dr. Felix Roque’s office at 543, 45th Street, Union City, New Jersey. 543 45th St, Union City, NJ 07087. Phone: (201) 766-6469. This center bills out of network for insurance.
W8MD’s affordable and delicious meal replacements start as low as $2.25 for each meal replaced and have been shown to not only help people lose weight but also save up to 15% on monthly grocery bills in an internal study!
As W8MD remains the only medical weight loss program in the area to work with health insurance for the weight loss physician visits, the demand is high and acceptance is limited, so call 1-800-W8MD-007 to make your appointment now or to learn more.
W8MD weight loss program reviews
He is a very good listener and takes time with you. He never rushes you like some doctors. His office appears to be hi tech also very clean.- Thomas C.
Excellent doctor, very thorough, knowledgeable, and caring. I’ve been fighting obesity for years with little or no result, and now my waistline is melting, and I feel great! I highly recommend Dr. Tumpati to everyone who wants a chance to a new life. – verified patient.
Extremely thorough, you will never feel rushed or neglected while talking with Dr. Tumpati. He takes the time to talk to you about everything.- verified patient