Neuropsychiatric safety with liraglutide 3.0mg for weight management: results from randomized controlled phase 2 and 3a trials.

MedStar author(s):
Citation: Diabetes, Obesity & Metabolism. 19(11):1529-1536, 2017 Nov.PMID: 28386912Institution: MedStar Health Research InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Anti-Obesity Agents/ae [Adverse Effects] | *Brain/de [Drug Effects] | *Liraglutide/ae [Adverse Effects] | *Neurotoxicity Syndromes/ep [Epidemiology] | *Obesity/dt [Drug Therapy] | Adult | Aged | Anti-Obesity Agents/ad [Administration & Dosage] | Brain/ph [Physiology] | Clinical Trials, Phase II as Topic/sn [Statistics & Numerical Data] | Clinical Trials, Phase III as Topic/sn [Statistics & Numerical Data] | Diabetes Mellitus, Type 2/co [Complications] | Diabetes Mellitus, Type 2/dt [Drug Therapy] | Diabetes Mellitus, Type 2/ep [Epidemiology] | Diabetes Mellitus, Type 2/px [Psychology] | Dose-Response Relationship, Drug | Double-Blind Method | Female | Humans | Liraglutide/ad [Administration & Dosage] | Male | Mental Disorders/ci [Chemically Induced] | Mental Disorders/ep [Epidemiology] | Mental Health | Middle Aged | Neuropsychological Tests | Obesity/co [Complications] | Obesity/ep [Epidemiology] | Obesity/px [Psychology] | Randomized Controlled Trials as Topic/sn [Statistics & Numerical Data] | Surveys and Questionnaires | Weight Loss/de [Drug Effects]=253 \\Year: 2017ISSN:
  • 1462-8902
Abstract: AIMS: Liraglutide, a GLP-1 receptor agonist, regulates appetite via receptors in the brain. Due to concerns over the potential of centrally-acting anti-obesity medications to affect mental health, pooled neuropsychiatric safety data from all phase 2 and 3a randomized, double-blind trials with liraglutide 3.0mg were evaluated post hoc.CONCLUSIONS: The results of this exploratory pooled analysis do not provide any cause for concern regarding the neuropsychiatric safety of treatment with liraglutide 3.0mg in patients similar to those individuals included in the examined trials. Although there was a small numerical imbalance in suicidal ideation with liraglutide through adverse event reporting, no between-treatment imbalances in suicidal ideation/behaviour or depression were noted through prospective questionnaire assessments.Copyright This article is protected by copyright. All rights reserved.METHODS: Data from the liraglutide weight-management programme were pooled. Across trials, individuals with a body mass index >30kg/m<sup>2</sup> or >27kg/m<sup>2</sup> with weight-related comorbidities were randomized to once-daily subcutaneous liraglutide 3.0mg (n=3384) or placebo (n=1941), both with a 500kcal/day deficit diet plus exercise. Adverse events related to neuropsychiatric safety were collected in all trials. Additionally, in the phase 3a trials, validated mental-health questionnaires were prospectively and systematically administered.RESULTS: In the pooled analysis of 5325 randomized and exposed individuals, rates of depression (2.1 versus 2.1 events/100 person-years) and anxiety (1.9 versus 1.7 events/100 person-years) through adverse event reporting were similarly low in the liraglutide group and the placebo group. Nine (0.3%) individuals on liraglutide and two (0.1%) on placebo reported adverse events of suicidal ideation or behaviour. In phase 3a trials, mean baseline Patient Health Questionnaire-9 scores of 2.8+/-3.0 versus 2.9+/-3.1 for liraglutide versus placebo improved to 1.8+/-2.7 versus 1.9+/-2.7 at treatment end; 34/3291 individuals (1.0%) on liraglutide 3.0mg versus 19/1843 (1.0%) on placebo reported suicidal ideation on the Columbia-Suicide Severity Rating Scale.All authors: Aroda VR, Astrup A, Brett J, Cancino A, Kushner R, Lau DC, O'Neil PM, Satiety and Clinical Adiposity - Liraglutide Evidence in individuals with and without diabetes (SCALE) study groups, Wadden TA, Wilding JPFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-05-06
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Journal Article MedStar Authors Catalog Article 28386912 Available 28386912

AIMS: Liraglutide, a GLP-1 receptor agonist, regulates appetite via receptors in the brain. Due to concerns over the potential of centrally-acting anti-obesity medications to affect mental health, pooled neuropsychiatric safety data from all phase 2 and 3a randomized, double-blind trials with liraglutide 3.0mg were evaluated post hoc.

CONCLUSIONS: The results of this exploratory pooled analysis do not provide any cause for concern regarding the neuropsychiatric safety of treatment with liraglutide 3.0mg in patients similar to those individuals included in the examined trials. Although there was a small numerical imbalance in suicidal ideation with liraglutide through adverse event reporting, no between-treatment imbalances in suicidal ideation/behaviour or depression were noted through prospective questionnaire assessments.

Copyright This article is protected by copyright. All rights reserved.

METHODS: Data from the liraglutide weight-management programme were pooled. Across trials, individuals with a body mass index >30kg/m<sup>2</sup> or >27kg/m<sup>2</sup> with weight-related comorbidities were randomized to once-daily subcutaneous liraglutide 3.0mg (n=3384) or placebo (n=1941), both with a 500kcal/day deficit diet plus exercise. Adverse events related to neuropsychiatric safety were collected in all trials. Additionally, in the phase 3a trials, validated mental-health questionnaires were prospectively and systematically administered.

RESULTS: In the pooled analysis of 5325 randomized and exposed individuals, rates of depression (2.1 versus 2.1 events/100 person-years) and anxiety (1.9 versus 1.7 events/100 person-years) through adverse event reporting were similarly low in the liraglutide group and the placebo group. Nine (0.3%) individuals on liraglutide and two (0.1%) on placebo reported adverse events of suicidal ideation or behaviour. In phase 3a trials, mean baseline Patient Health Questionnaire-9 scores of 2.8+/-3.0 versus 2.9+/-3.1 for liraglutide versus placebo improved to 1.8+/-2.7 versus 1.9+/-2.7 at treatment end; 34/3291 individuals (1.0%) on liraglutide 3.0mg versus 19/1843 (1.0%) on placebo reported suicidal ideation on the Columbia-Suicide Severity Rating Scale.

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