REAL-WORLD COMPARATIVE EFFECTIVENESS OF SEMAGLUTIDE 2.4 MG VERSUS OTHER COMMERCIALLY AVAILABLE MEDICATIONS FOR CHRONIC WEIGHT MANAGEMENT IN ADULTS WITH OBESITY IN THE UNITED STATES: A PRAGMATIC CLINICAL STUDY
Author(s)
Warren Peters, MD1, Tea Monk Fries, MD, PhD2, Shilpa Middolu, MS3, Lauren Wilson, MPH4, Scott H. Lee, MD5;
1Loma Linda University, Loma Linda, CA, USA, 2Novo Nordisk, Plainsboro, NJ, USA, Plainsboro, NJ, USA, 3Novo Nordisk, Inc., Bengaluru, India, 4Novo Nordisk, Inc., Plainsboro, NJ, USA, 5United Gastroenterologists, Yorba Linda, CA, USA
1Loma Linda University, Loma Linda, CA, USA, 2Novo Nordisk, Plainsboro, NJ, USA, Plainsboro, NJ, USA, 3Novo Nordisk, Inc., Bengaluru, India, 4Novo Nordisk, Inc., Plainsboro, NJ, USA, 5United Gastroenterologists, Yorba Linda, CA, USA
OBJECTIVES: To demonstrate the real-world comparative effectiveness of once-weekly subcutaneous semaglutide 2.4 mg versus other commercially available anti-obesity medications (AOMs) on body weight reduction in adults with obesity in a multiple-employer US setting.
METHODS: This was a 52-week, randomized, open-label, parallel-group, active comparator-controlled, pragmatic study (NCT05579249). Participants were aged ≥18 years, had body mass index ≥30.0 kg/m2, were employed at Loma Linda University or Inland Empire Health Plan, and had no history of type 1 or type 2 diabetes mellitus. Following the investigators’ decision to initiate treatment for chronic weight management, participants were randomized 1:1 to semaglutide 2.4 mg or other AOMs. The primary endpoint was ≥10% body weight reduction. Secondary confirmatory endpoints were change in body weight and physical function measured by the Impact of Weight on Quality of Life-Lite Clinical Trials Version (IWQOL-Lite-CT). Results are presented for the treatment policy estimand, which assesses treatment effects regardless of adherence.
RESULTS: Of 565 screened participants, 500 were randomized and 311 (62.2%) completed treatment (semaglutide 2.4 mg, n=176 [70.4%]; other AOMs, n=135 [54.0%]). The most common other AOMs were liraglutide (58.3%) and phentermine/topiramate (39.7%). A significantly greater proportion of participants treated with semaglutide 2.4 mg (63.8%) achieved body weight reduction ≥10% at week 52 versus other AOMs (34.5%; odds ratio, 3.2 [95% CI: 2.1, 4.8]; P<0.0001). Mean change in body weight was significantly greater with semaglutide 2.4 mg (−11.9%) versus other AOMs (−6.3%; estimated treatment difference [ETD], −5.6% [−7.2%, −4.0%]; P<0.0001). Slightly greater improvements in IWQOL-Lite-CT physical function score were observed with semaglutide 2.4 mg versus other AOMs (23.0 vs 19.0 points) but this difference was not significant (ETD, 4.0 [−2.3, 10.2]; P=0.2126). Safety and tolerability were consistent with the established profile of semaglutide.
CONCLUSIONS: These findings demonstrate real-world effectiveness of semaglutide 2.4 mg comparable to that observed in phase 3 randomized controlled trials.
METHODS: This was a 52-week, randomized, open-label, parallel-group, active comparator-controlled, pragmatic study (NCT05579249). Participants were aged ≥18 years, had body mass index ≥30.0 kg/m2, were employed at Loma Linda University or Inland Empire Health Plan, and had no history of type 1 or type 2 diabetes mellitus. Following the investigators’ decision to initiate treatment for chronic weight management, participants were randomized 1:1 to semaglutide 2.4 mg or other AOMs. The primary endpoint was ≥10% body weight reduction. Secondary confirmatory endpoints were change in body weight and physical function measured by the Impact of Weight on Quality of Life-Lite Clinical Trials Version (IWQOL-Lite-CT). Results are presented for the treatment policy estimand, which assesses treatment effects regardless of adherence.
RESULTS: Of 565 screened participants, 500 were randomized and 311 (62.2%) completed treatment (semaglutide 2.4 mg, n=176 [70.4%]; other AOMs, n=135 [54.0%]). The most common other AOMs were liraglutide (58.3%) and phentermine/topiramate (39.7%). A significantly greater proportion of participants treated with semaglutide 2.4 mg (63.8%) achieved body weight reduction ≥10% at week 52 versus other AOMs (34.5%; odds ratio, 3.2 [95% CI: 2.1, 4.8]; P<0.0001). Mean change in body weight was significantly greater with semaglutide 2.4 mg (−11.9%) versus other AOMs (−6.3%; estimated treatment difference [ETD], −5.6% [−7.2%, −4.0%]; P<0.0001). Slightly greater improvements in IWQOL-Lite-CT physical function score were observed with semaglutide 2.4 mg versus other AOMs (23.0 vs 19.0 points) but this difference was not significant (ETD, 4.0 [−2.3, 10.2]; P=0.2126). Safety and tolerability were consistent with the established profile of semaglutide.
CONCLUSIONS: These findings demonstrate real-world effectiveness of semaglutide 2.4 mg comparable to that observed in phase 3 randomized controlled trials.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
P6
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), STA: Multiple/Other Specialized Treatments