Victoza (liraglutide) for Weight Loss Management in Obesity | Mai Nguyen, PharmD | RxEconsult

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Victoza (liraglutide) for Weight Loss Management Category: Diabetes by - November 7, 2012 | Views: 12882 | Likes: 2 | Comment: 0  

Victoza (liraglutide) in obese non-diabetics

What is Victoza (liraglutide)

Victoza (liraglutide) is an injectable medication used in combination with diet and exercise to reduce blood sugar in patients with type II diabetes mellitus. By acting like human GLP-1 hormone (incretin hormone), it stimulates insulin secretion by the pancreas, slows the absorption of sugar from the gut and reduces appetite by delaying movement of food through the gut. Victoza is not recommended as a first line therapy for type II diabetes and should not be given to patients with type I diabetes, or diabetic ketoacidosis.

There is evidence that weight loss occurs in obese patients who are taking Victoza. However, it is currently not approved for weight loss or management of obesity. Patients exploring the use of Victoza purely for weight loss should fully understand the risks and benefits of Victoza.

How does Victoza cause weight loss

Victoza acts like human GLP-1 hormone. Its effects are on the gut and the brain, where several GLP-1 receptors are located. It suppresses appetite, decreases the absorption of sugar from the gut, and delays movement of food through the gut. Victoza causes patients to feel fuller for a longer time. Victoza’s role in weight management is dose-dependent, ranging from 1.2 mg to 3.0 mg per day (that’s higher than the recommended approval dose for the treatment of type 2 diabetes).

Victoza study in weight management in non-diabetic obese patients

Obesity Development Program-SCALE study

  • Assessed the effects of Victoza on weight loss at doses up to 3 mg per day in conjunction with a low calorie diet and exercise in 564 obese patients for 20 weeks.
  • Patients were randomly assigned to one of four Victoza doses (1.2 mg, 1.8 mg, 2.4 mg, or 3 mg) administered once daily in comparison to placebo and Orlistat 120 mg three times daily orally.

Weight Loss in Victoza Obesity Study (SCALE Study)

Victoza Obesity Weight Loss Study (SCALE) Results

Results from the study:

  • Average weight loss with Victoza 3 mg per day was 7.2 kg (5-10% weight reduction) compared to 2.8 kg (placebo) and 4.1 kg (Orlistat).
  • 76% patients lost more than 5% weight, and almost 30% lost more than 10% weight after 20 weeks of treatment.
  • More than 50% of patients treated with Victoza achieved the target of 5-10% weight reduction.
  • Nausea/vomiting were more frequent with Victoza than with other treatments.

What are the possible side effects of Victoza

Common: headaches, nausea, diarrhea

Serious: Pancreatitis and thyroid tumor

Do not start Victoza if you have…

  • History of thyroid tumor/thyroid cancer
  • Family members with medullary thyroid cancer, or multiple endocrine neoplasia syndrome type 2.
  • History of pancreas inflammation
  • Gallbladder Stones
  • A history of alcoholism
  • High blood triglyceride levels

Benefit versus risk associated with Victoza

The use of Victoza for promoting weight loss is an ongoing research and clinical data and efficacy are not yet established. It is highly recommended that patients discuss the risk/benefit associated with Victoza with their doctor before starting the medication.

Victoza is beneficial for promoting with loss in patients who are:

Diagnosed Type II diabetes + Obese

Diagnosed Type II diabetes + Overweight

Diagnosed Type II diabetes + uncontrolled blood sugar levels

FDA approval has been granted for the above 3 population since efficacy has been proven with the management of blood sugar levels in type II diabetes patients.

Victoza is being studied for patients who are:

Non-diabetic + Obese

Non-diabetic + Overweight

Victoza has not been approved by the FDA for weight management in patients without Type II diabetes. Therefore, it is important that patients weigh side effects associated with Victoza such as higher frequency of nausea and vomiting, episodes of psychiatric disorders, inflammation of the pancreas, and medullary thyroid cancer against the potential benefit for weight loss.

Cost information plus Insurance coverage options

  • 3 pens of 18 mg/3 ml Victoza 1 carton: $445-$495
  • Victoza Instant Savings Card Program: Saving up to $25 on your first 24 Victoza prescriptions.
  • Victoza eVoucherRx coverage: Automatic copay reduction right at the pharmacy counter.
  • Insurance Plan Coverage: Victoza is covered by most major health plans, including Medicare and Medicaid for diagnosed type II diabetes mellitus only.

Should Victoza be used for weight loss in individuals without diabetes

  • Victoza is approved by the FDA in combination with diet and exercise to improve blood sugar control in adults with type II diabetes mellitus.
  • Victoza is NOT FDA approved for weight loss management in patients without diabetes since safety and efficacy have not been established for this use.
  • Clinical trials evaluating the efficacy of Victoza in the management of obesity in patients without diabetes used doses up to 3.0 mg per day (which is higher than the 1.8 mg per day approved dose for type II diabetes patients) and was associated with higher frequency of side effects. Average weight loss was 7.2 kg with the 3 mg dose.
  • Victoza is NOT covered by most insurance companies for management of obesity in non-diabetic patients.
  • Patients should carefully weigh the risks and cost of Victoza before using it as a weight loss drug.

Related Articles

Victoza for diabetes treatment

Victoza vs Bydureon

Byetta (exenatide) for Diabetes Treatment

Bydureon for Diabetes Treatment

References

Arne Strup et al. Effects of liraglutide in the treatment of obesity: a randomized, double blind, placebo-controlled study. Lancet 2009: 374:1606-16.

Victoza FDA Prescribing Information and Medication Guide.

Gansz Bobo, ElaineElaine. "News & Events." FDA Approves New Treatment for Type 2 Diabetes. FDA U.S. Food and Drug Admin.

Liraglutide Helps Non-diabetics Keep the Weight Off. Internal Medicine News

 

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