One‐year follow‐up on liraglutide treatment for prediabetes and overweight/obesity in clozapine‐ or olanzapine‐treated patients

• Published in: Acta psychiatrica Scandinavica Vol. 139; no. 1; pp. 26 - 36
• Main Authors: Svensson, C. K., Larsen, J. R., Vedtofte, L., Jakobsen, M. S. L., Jespersen, H. R., Jakobsen, M. I., Koyuncu, K., Schjerning, O., Nielsen, J., Ekstrøm, C. T., Correll, C. U., Vilsbøll, T., Fink‐Jensen, A.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-01-2019
• Subjects: Adolescent; Adult; Aged; Antipsychotic Agents - adverse effects; Antipsychotic Agents - therapeutic use; Antipsychotics; Blood Glucose - drug effects; Body weight; Body Weight - drug effects; Body weight gain; Body weight loss; C-Peptide - drug effects; Clozapine; Clozapine - adverse effects; Clozapine - therapeutic use; Denmark - epidemiology; Fasting; Female; Follow-Up Studies; GLP‐1; Glucagon; Glucagon-Like Peptide-1 Receptor - agonists; Glycated Hemoglobin A - drug effects; Hemoglobin; Humans; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - pharmacology; Hypoglycemic Agents - therapeutic use; Lipid Metabolism - drug effects; Lipids; liraglutide; Liraglutide - administration & dosage; Liraglutide - pharmacology; Liraglutide - therapeutic use; Male; Mental disorders; Metabolism; Middle Aged; Obesity; Obesity - chemically induced; Obesity - drug therapy; Obesity - epidemiology; Olanzapine; Olanzapine - adverse effects; Olanzapine - therapeutic use; Overweight; Overweight - chemically induced; Overweight - drug therapy; Overweight - epidemiology; Patients; Peptides; Placebos - administration & dosage; prediabetes; Prediabetic State - chemically induced; Prediabetic State - drug therapy; Prediabetic State - epidemiology; Schizophrenia; Schizophrenia - blood; Schizophrenia - diagnosis; Schizophrenia - drug therapy; Young Adult; Denmark; liraglutide; olanzapine; GLP-1; prediabetes; clozapine; schizophrenia; overweight
• ISSN: 0001-690X; 1600-0447
• DOI: 10.1111/acps.12982

Objective
Treatment with most antipsychotics is associated with an increased risk of weight gain and metabolic disturbances. In a randomized trial, we previously demonstrated that 16 weeks of glucagon‐like peptide‐1 receptor agonist liraglutide treatment vs. placebo significantly reduced glucometabolic disturbances and body weight in prediabetic, overweight/obese schizophrenia‐spectrum disorder patients treated with clozapine or olanzapine. The aim of this study was to investigate whether the beneficial effects of the 16‐week intervention were sustained beyond the intervention period.
Method
One year after completion of the intervention, we investigated changes in body weight, fasting glucose, glycated hemoglobin, C‐peptide, and lipids comparing 1‐year follow‐up levels to end of treatment (week 16) and baseline (week 0) levels.
Results
From end of treatment to the 1‐year follow‐up, body weight had increased in the liraglutide‐treated group. However, compared to baseline levels, the placebo‐subtracted body weight loss remained significantly reduced (−3.8 kg, 95% CI: −7.3 to −0.2, P = 0.04). Fasting glucose, glycated hemoglobin, C‐peptide, and lipids had each returned to baseline levels 1 year after stopping liraglutide.
Conclusion
The body weight reduction during 16 weeks of liraglutide treatment was partially sustained 1 year after the intervention was completed. However, the improvements in other metabolic parameters returned to baseline levels.