Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial

Obesity is a chronic condition that impacts several aspects of life. Long-term weight maintenance is a challenging task. Short-term treatment with anti-obesity medications fail to maintain weight in the longer run. From the previous steps it could be observed that semaglutide resulted in weight loss thereby improving various metabolic outcomes. However, it could not be known what outcome would be obtained if the therapy was discontinued. Hence, Niclas Abrahamsson and colleagues conducted a research titled “Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial” and the summary has been given below:

Objective:

To differentiate between once-a-week therapy with subcutaneous semaglutide 2.4 mg with change to placebo for maintaining weight (both with lifestyle intervention) in adults with corpulence following a 20-week altercation with subcutaneous semaglutide titrated to 2.4 mg once-a-week.

Methods:

The study was a randomized, double-blind, 68-week, phase 3a withdrawal preliminary conducted at 73 different places in adults with a BMI of 30 kg/m2 with weight-associated comorbidity without diabetes. 902 participants were administered with once-a-week semaglutide and post 20 weeks 803 participants who reached the dosage were randomized (2:1) for a period of 48 weeks of continued semaglutide or transferred to placebo in addition to lifestyle modifications in both groups. Gastrointestinal events were reported to be frequent in those who continued the semaglutide treatment vs placebo.

Findings:

The outcomes that were significant included changes in the weight, waistline, systolic blood pressure, glucose metabolism and physical functioning. Hence individuals with obesity who accomplished a 20-week run in period on 2.4 dosage of subcutaneous semaglutide keeping them on the same treatment vs transferring them to placebo resulted in consistent weight reduction over the accompanying 48 weeks.
Given the modest potency of presently approved drugs semaglutide may offer the possibility to overcome any issues among behavioral and pharmacological and bariatric medical procedure, which is at present thought to be the best mediation accessible for weight management.

Limitations:

The study was limited to those participants who were able to tolerate the strict dose titration schedule. There was no evaluation of conformity to lifestyle intervention. The study could result in selection bias and exaggeration of weight loss with persistent administration of semaglutide compared to what can be expected in a normal individual.

Image Credit : People photo created by shurkin_son – www.freepik.com