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LETTER TO EDITOR
Year : 2019  |  Volume : 8  |  Issue : 7  |  Page : 2551-2552  

Monotherapy with liraglutide – Points to be focussed


1 Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Raipur, Chhattisgarh, India
2 Department of Clinical Division, Central Leprosy Teaching and Research Institute, Chengalpattu, Tamil Nadu, India

Date of Submission01-Jun-2019
Date of Decision05-Jun-2019
Date of Acceptance17-Jun-2019
Date of Web Publication31-Jul-2019

Correspondence Address:
Dr. Pugazhenthan Thangaraju
Department of Pharmacology, All India Institutes of Medical Sciences (AIIMS), Raipur, Chhattisgarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jfmpc.jfmpc_435_19

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How to cite this article:
Thangaraju P, Venkatesan S. Monotherapy with liraglutide – Points to be focussed. J Family Med Prim Care 2019;8:2551-2

How to cite this URL:
Thangaraju P, Venkatesan S. Monotherapy with liraglutide – Points to be focussed. J Family Med Prim Care [serial online] 2019 [cited 2019 Aug 21];8:2551-2. Available from: http://www.jfmpc.com/text.asp?2019/8/7/2551/263818



Sir,

We read with great interest a case study “Short-term monotherapy with liraglutide for weight management: A case study” by Almarshad.[1] It is a nice case study to be discussed as the person has marked 16 kg reduction with drug, exercise, and diet control strategy. We have some valid points to be added for betterment in people like him in future. The authors have agreeably given the parameters initially and after treatment. It is good that none of the parameters has been elevated. But we still feel that the potassium and sodium mildly increased but within range within this short period. So, it should be stressed in future that there should be some vigilance in the electrolyte parameters. In addition, the same applies to renal parameters such as urea and creatinine. Hence, in future if the same patient comes for follow-up or needs the drug to be continued, these parameters should be taken care off.

Another important thing that should be detailed is regarding any side effects or adverse effects seen in this case as drug molecules have the property of causing pancreatitis and renal pathologies. Hence, a mention of this drug-related adverse should be documented in the current and the future follow-up period for better safety. Since in this case there was a good reduction in 5 weeks, it is mandate to have a good pharmacovigilance profile.

The most important point to be focussed in feature is that this patient is otherwise healthy person. Generally, the drug is approved for obesity with criteria consisting of body mass index more than 30 kg/m 2 with hypertension, diabetes, and/or dyslipidemia.[2] It has been shown in the two available double-blinded studies that liraglutide resulted in an average of 4–6 kg greater weight loss in more than 3000 obese and/or overweight patients with associated hypertension, diabetes, and/or hyperlipidemias with lifestyle modification for 1 year.[3],[4],[5],[6]

Another advice we suggest strongly in this case or in future to the author is that there should be a correlation of drug dosage and weight reduction in week basis. This will further help the range of dose the patient started response as antiobesity action because anti-obesity actions will happen only at higher doses.[7],[8] It was mentioned in the literature that liraglutide 3 mg has caused decrease in body weight of more than 5% to a maximum of 15%[9] In this case, it is 13.55%. But actually an increase in dosage was reached in the fifth week only. So we felt if there is serial measurement of weight in every week we would nicely correlated the anti-obesity action.

In conclusion, this case is a good signal supporting the evidence as antiobesity and could be tried with utmost caution in people seeking obesity management along with diet and mild exercises.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Almarshad F. Short-term Monotherapy with Liraglutide for weight management: A case study. J Family Med Prim Care 2019;8:1804-6.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Liraglutide Monograph for Professionals. Drugs.com. American Society of Health-System Pharmacists. Retrieved 2019 Jun 01.  Back to cited text no. 2
    
3.
Davies MJ, Bergenstal R, Bode B, Kushner RF, Lewin A, Skjøth TV, et al. Efficacy of liraglutide for weight loss among patients with type 2 diabetes: The SCALE diabetes randomized clinical trial. JAMA 2015;314:687-99.  Back to cited text no. 3
    
4.
Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, et al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med 2015;373:11-22.  Back to cited text no. 4
    
5.
Lean ME, Carraro R, Finer N, Hartvig H, Lindegaard ML, Rössner S, et al. Tolerability of nausea and vomiting and associations with weight loss in a randomized trial of liraglutide in obese, non-diabetic adults. Int J Obes (Lond) 2014;38:689-97.  Back to cited text no. 5
    
6.
Whitten JS. Liraglutide (Saxenda) for weight loss. Am Fam Physician 2016;94:161-6.  Back to cited text no. 6
    
7.
Astrup A, Rossner S, Van Gaal L, Rissanen A, Niskanen L, Al Hakim M, et al. Effects of liraglutide in the treatment of obesity: A randomised, double blind, placebo-controlled study. Lancet 2009;374:1606-16.  Back to cited text no. 7
    
8.
Davies MJ, Bergenstal R, Bode B, Kushner RF, Lewin A, Skjoth TV, et al. Efficacy of liraglutide for weight loss among patients with type 2 diabetes the SCALE diabetes randomized clinical trial. JAMA 2015;314:687-99.  Back to cited text no. 8
    
9.
Vilsboll T, Christensen M, Junker AE, Knop FK, Gluud LL. Effects of glucagon like peptide-1 receptor agonists on weight loss: Systematic review and meta-analyses of randomised controlled trials. BMJ 2012;344:d7771.  Back to cited text no. 9
    




 

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