EFFECTIVENESS AND SAFETY OF GLP-1 RECEPTOR AGONISTS IN PATIENTS WITH WEIGHT RECURRENCE AFTER BARIATRIC SURGERY: A REAL-WORLD STUDY
Author(s)
Rotana M. Radwan, PharmD, PhD1, Tarik Yuce, MD2, Yao An Lee, MS2, Emma Holler, PhD2, Hao Dai, PhD2, Xing He, PhD2, Yu Huang, PhD2, Yi Guo, PhD3, Jiang Bian, PhD4, Jingchuan Guo, MD, PhD5;
1Purdue University, Indianapolis, IN, USA, 2Indiana University, Indianapolis, IN, USA, 3University of Florida, Gainesville, FL, USA, 4Indiana University Indianapolis, Indianapolis, IN, USA, 5Purdue University College of Pharmacy, Indianapolis, IN, USA
1Purdue University, Indianapolis, IN, USA, 2Indiana University, Indianapolis, IN, USA, 3University of Florida, Gainesville, FL, USA, 4Indiana University Indianapolis, Indianapolis, IN, USA, 5Purdue University College of Pharmacy, Indianapolis, IN, USA
OBJECTIVES: Weight recurrence affects approximately 20% of patients following metabolic and bariatric surgery (MBS). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used to manage post-MBS weight recurrence; however, real-world evidence on newer agents remains limited. This study evaluated the effectiveness and safety of GLP-1RAs among patients experiencing post-MBS weight recurrence.
METHODS: A retrospective cohort study was conducted using the OneFlorida+ Data Trust (2015-2024), including adults with ≥10% weight recurrence following MBS. GLP-1RA users were compared with propensity score-matched non-users. Inverse probability of treatment weighting was applied to address residual confounding. The primary effectiveness outcome was the percentage of recurrent weight lost at 6 and 12 months, assessed using weighted two-sample t-tests. Safety outcomes, including gastrointestinal and post-bariatric adverse events, were evaluated using Cox proportional hazards models. Subgroup analyses examined individual GLP-1RA agents and type 2 diabetes status.
RESULTS: GLP-1RA users achieved significantly greater recurrent weight loss at 6 months (9.6% vs 4.3%, p=0.005) and 12 months (14.8% vs 8.1%, p=0.017) compared with non-users. Tirzepatide demonstrated the greatest recurrent weight loss at both 6 months (25.1% vs 5.4%, p<0.001) and 12 months (34.4% vs 8.8%, p<0.001). Liraglutide was associated with significant recurrent weight loss at 12 months (18.3% vs 8.4%, p=0.004), whereas semaglutide and dulaglutide showed no statistically significant differences. Among patients with type 2 diabetes, GLP-1RAs were effective at 6 months (13.6% vs 4.6%, p=0.007); among those without diabetes, significant benefit emerged at 12 months (14.6% vs 7.1%, p=0.016). Adverse event rates were comparable between groups, with no increased risk associated with GLP-1RA use.
CONCLUSIONS: GLP-1RAs, particularly tirzepatide and liraglutide, were associated with clinically meaningful recurrent weight loss following MBS without an increased risk of adverse events, supporting their use for the management of post-MBS weight recurrence.
METHODS: A retrospective cohort study was conducted using the OneFlorida+ Data Trust (2015-2024), including adults with ≥10% weight recurrence following MBS. GLP-1RA users were compared with propensity score-matched non-users. Inverse probability of treatment weighting was applied to address residual confounding. The primary effectiveness outcome was the percentage of recurrent weight lost at 6 and 12 months, assessed using weighted two-sample t-tests. Safety outcomes, including gastrointestinal and post-bariatric adverse events, were evaluated using Cox proportional hazards models. Subgroup analyses examined individual GLP-1RA agents and type 2 diabetes status.
RESULTS: GLP-1RA users achieved significantly greater recurrent weight loss at 6 months (9.6% vs 4.3%, p=0.005) and 12 months (14.8% vs 8.1%, p=0.017) compared with non-users. Tirzepatide demonstrated the greatest recurrent weight loss at both 6 months (25.1% vs 5.4%, p<0.001) and 12 months (34.4% vs 8.8%, p<0.001). Liraglutide was associated with significant recurrent weight loss at 12 months (18.3% vs 8.4%, p=0.004), whereas semaglutide and dulaglutide showed no statistically significant differences. Among patients with type 2 diabetes, GLP-1RAs were effective at 6 months (13.6% vs 4.6%, p=0.007); among those without diabetes, significant benefit emerged at 12 months (14.6% vs 7.1%, p=0.016). Adverse event rates were comparable between groups, with no increased risk associated with GLP-1RA use.
CONCLUSIONS: GLP-1RAs, particularly tirzepatide and liraglutide, were associated with clinically meaningful recurrent weight loss following MBS without an increased risk of adverse events, supporting their use for the management of post-MBS weight recurrence.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
PT37
Topic
Clinical Outcomes
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), STA: Surgery