Introduction and Objective: Despite the increase in the use of anti-obesity medication (AOM) since the approval of glucagon-like peptide-1 agonists, the changes in cardiometabolic risk profile after discontinuation of AOM in real-life are still unknown, challenging the projection of long-term value. The aim of this study was to project the trajectory of body-mass index (BMI) and blood pressure during and post AOM use.Methods: A retrospective cohort study was conducted using healthcare records between 01/2016 and 03/2024 from a State-Sponsored Healthcare System. The study cohort comprised individuals with BMI≥ 25 kg/m2 who received AOMs with weight management indication. The cumulative incidence of AOM discontinuation was summarized using the Kaplan-Meier estimator, where discontinuation was defined by the end of AOM supply from the last dispensing date. Using a linear-mixed effect modeling, BMI and systolic blood pressure (SBP) changes up to one-year during the AOM use and after the discontinuation were projected. The trajectory was adjusted for the impact of baseline BMI and AOM effect.Results: The analytic cohort consisted of 1,679 individuals, with 91% females and average age of 43 years. The majority of the selected patients were on either phentermine-topiramate (71%) or semaglutide (20%). Rate of treatment discontinuation varied by AOM, ranged between 30 – 64% at 6 months and 50 – 80% at 1 year after the initial dispensing. The one-year projected changes in BMI and SBP on continuous AOM use were -2.8 kg/m2 and -1.3 mmHg, respectively, from the average BMI of 40 kg/m2 and SBP of 131 mmHg. Patients who achieved the average benefit from the AOM were projected to regain 3.4 kg/m2 in BMI and 4.2 mmHg in SBP in the year following the discontinuation.Conclusion: The estimated rebounds in BMI and SBP after the AOM discontinuation exceed the benefits observed in the average individuals. Our preliminary data warrants further studies on the effect of AOM persistence and discontinuation on various effectiveness measures in a larger cohort.
K. Kim: Consultant; Renalytix. Other Relationship; Takeda Pharmaceutical Company. L. Khoja: None. E.M. Okpara: None.
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