Drugs such as semaglutide are associated with increased risk of gastrointestinal problems when used for weight loss, researchers have warned.
In an analysis published in the Journal of the American Medical Association, use of semaglutide and liraglutide for weight loss was associated with an increased risk of pancreatitis, bowel obstruction and gastroparesis, compared with patients taking other weight-loss drug bupropion-naltrexone.
But there was no increased risk of biliary disease in the cohort, the researchers reported.
Previous studies have found increased risk of gastrointestinal adverse events with use of glucagon-like peptide 1 (GLP-1) agonists in patients with diabetes.
But studies of their use in weight loss were not designed to capture this because they were small or had short follow up, the research team from the University of British Columbia explained.
They analysed 4,144 patients on liraglutide, 613 patients on semaglutide and 654 patients on bupropion-naltrexone who had recent obesity code in their medical records but not diabetes.
Although the numbers of adverse events were small, the adjusted results showed a nine times increased risk of pancreatitis, four times increased risk of bowel obstruction and three and a half times increased risk of gastroparesis.
The Canadian researchers concluded: ‘Given the wide use of these drugs, these adverse events, although rare, must be considered by patients who are contemplating using the drugs for weight loss because the risk-benefit calculus for this group might differ from that of those who use them for diabetes.’
Semaglutide, marketed as Wegovy, first became available on the NHS as a weight-loss drug in September, after a limited stock was earmarked to fulfil new NICE guidance.
Manufacturer Novo Nordisk announced that Wegovy will be available in specialist NHS weight management services for people who meet the NICE criteria, or privately through a registered healthcare professional, through a ‘controlled and limited launch’.
It follows the recommendation in March from NICE that the drug could be used for the first time as part of a patient’s treatment for obesity in an NHS specialist weight management service and with the support of a multi-disciplinary team.
But the move has happened amidst ongoing shortages of semaglutide due to global demand for the drug with patients for type 2 diabetes having to stop taking GLP-1 RAs due to supply issues.
There are also plans to test how GPs could safely prescribe obesity drugs.
A two-year pilot backed by up to £40 million will ‘explore ways to make obesity drugs accessible to patients living with obesity outside of hospital settings’, the Government has announced today as part of plans to reduce pressure on the NHS and cutting waiting lists.