November 2023

ENDOCRINOLOGY

EFFICACY AND SAFETY OF SEMAGLUTIDE 2.4 MG ACCORDING TO ANTIDEPRESSANT USE AT BASELINE: A POST HOC SUBGROUP ANALYSIS

Featuring: Robert K. Kushner, MD

The article, published in Obesity,  “The efficacy and safety of semaglutide 2.4 mg according to antidepressant use at baseline: A post hoc subgroup analysis”,  explores the effectiveness and safety of semaglutide 2.4 mg in individuals with overweight or obesity who were also being treated with antidepressants (ADs). The study was conducted across the Semaglutide Treatment Effect for People with obesity (STEP) 1-3 and 5 trials, enrolling adults with overweight/obesity and type 2 diabetes (STEP 2 only). Participants with severe major depressive disorder within 2 years prior to screening or with a patient health questionnaire-9 score ≥15 at screening were excluded. The participants were categorized into subgroups based on their baseline AD status (on/off ADs).

The results showed that out of 3683 participants randomized, 539 were on ADs at baseline. The mean body weight change from baseline to week 68 was greater for semaglutide versus placebo, regardless of baseline AD use. In STEP 1, for participants on ADs at baseline, the mean change from baseline was -15.7% with semaglutide versus -0.2% with placebo and -14.7% versus -2.8% for those not on ADs at baseline. Similar patterns were observed in STEP 2, 3, and 5. The prevalence of adverse events (AEs) was generally similar between semaglutide and placebo in participants on ADs at baseline.

​The study found that in adults with overweight/obesity, semaglutide provided clinically meaningful weight loss regardless of baseline AD use, with an AE profile consistent with previous studies. This suggests that semaglutide could be a viable treatment option for weight loss in this population.
 
Listen to Dr. Kushner in this episode of BetterEdge as he discusses the new obesity management drug, and changing the conversation from weight loss to improved health.
Robert K. Kushner, MD is a Professor of Endocrinology and Medical Education.

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