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Ian J. Neeland, MD: Benefit of Liraglutide on Patients with Obesity, High CV Risk

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New data show liraglutide reduced visceral, ectopic fat, with greater effects seen compared to weight loss.

A randomized clinical trial investigated the effect of liraglutide, a glucagon-like peptide 1 receptor agonist that reduces weight and cardiovascular (CV) events compared to placebo, on body fat distribution in a high-risk population.

Patients aged ≥35 years with BMI ≥30 kg/m2 or ≥27 kg/m2 with metabolic syndrome were assigned liraglutide (3.0mg.ml) or placebo.

After a median 36-week treatment, data show liraglutide had a reduction in visceral/ectopic fat. Investigators noted proportionally greater effects in the abdominal viscera at 2 times greater and 6 times greater in the liver, compared with overall body weight.

The study was presented at the 2021 American Diabetes Association (ADA) Virtual Meeting.

In an interview with HCPLive, lead investigator, Ian J. Neeland, MD, University Hospitals Cleveland Medical Center, noted that the investigators saw liraglutide reduced visceral adipose tissue by a placebo-corrected tissue of about 11%.

Data also saw significant reduction in liver fat by 33% and reductions in inflammation and fasting glucose.

Dr. Neeland also noted that despite the COVID-19 pandemic, the trial was finished, appropriate participants were collected, and patients lost about 6% of their body weight.

Further, he spoke on the makeup of the patient population, including female predominance and diversity, as well as potential quality of life improvements from treatment.

He noted that with this type of weight loss and visceral adipose tissue reduced at 2 times relative to weight, weight loss is not the only factor and there needs to be more personalized medicine for each patient.

"Weight alone should not be the biomarker of choice for success," Neeland said. "You can have someone who doesn't lose a lot of body weight, but can reduce the visceral and liver fat significantly, and that can have long-lasting health effects."

The study, "Effects of Liraglutide on Visceral and Ectopic Fat in Adults with Overweight/Obesity at High Cardiovascular Risk: A Randomized Clinical Trial," was published online by ADA 2021.

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