Cited by 1,198Pharmacology and Obesity TreatmentDiabetes Treatment and ManagementBariatric Surgery and Outcomes

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Efficacy of Liraglutide for Weight Loss Among Patients With Type 2 Diabetes: The SCALE Diabetes Randomized Clinical Trial

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Abstract

IMPORTANCE: Weight loss of 5% to 10% can improve type 2 diabetes and related comorbidities. Few safe, effective weight-management drugs are currently available. OBJECTIVE: To investigate efficacy and safety of liraglutide vs placebo for weight management in adults with overweight or obesity and type 2 diabetes. DESIGN, SETTING, AND PARTICIPANTS: Fifty-six-week randomized (2:1:1), double-blind, placebo-controlled, parallel-group trial with 12-week observational off-drug follow-up period. The study was conducted at 126 sites in 9 countries between June 2011 and January 2013. Of 1361 participants assessed for eligibility, 846 were randomized. Inclusion criteria were body mass index of 27.0 or greater, age 18 years or older, taking 0 to 3 oral hypoglycemic agents (metformin, thiazolidinedione, sulfonylurea) with stable body weight, and glycated hemoglobin level 7.0% to 10.0%. INTERVENTIONS: Once-daily, subcutaneous liraglutide (3.0 mg) (n = 423), liraglutide (1.8 mg) (n = 211), or placebo (n = 212), all as adjunct to 500 kcal/d dietary deficit and increased physical activity (≥150 min/wk). MAIN OUTCOMES AND MEASURES: Three coprimary end points: relative change in weight, proportion of participants losing 5% or more, or more than 10%, of baseline weight at week 56. RESULTS: Baseline weight was 105.7 kg with liraglutide (3.0-mg dose), 105.8 kg with liraglutide (1.8-mg dose), and 106.5 kg with placebo. Weight loss was 6.0% (6.4 kg) with liraglutide (3.0-mg dose), 4.7% (5.0 kg) with liraglutide (1.8-mg dose), and 2.0% (2.2 kg) with placebo (estimated difference for liraglutide [3.0 mg] vs placebo, -4.00% [95% CI, -5.10% to -2.90%]; liraglutide [1.8 mg] vs placebo, -2.71% [95% CI, -4.00% to -1.42%]; P < .001 for both). Weight loss of 5% or greater occurred in 54.3% with liraglutide (3.0 mg) and 40.4% with liraglutide (1.8 mg) vs 21.4% with placebo (estimated difference for liraglutide [3.0 mg] vs placebo, 32.9% [95% CI, 24.6% to 41.2%]; for liraglutide [1.8 mg] vs placebo, 19.0% [95% CI, 9.1% to 28.8%]; P < .001 for both). Weight loss greater than 10% occurred in 25.2% with liraglutide (3.0 mg) and 15.9% with liraglutide (1.8 mg) vs 6.7% with placebo (estimated difference for liraglutide [3.0 mg] vs placebo, 18.5% [95% CI, 12.7% to 24.4%], P < .001; for liraglutide [1.8 mg] vs placebo, 9.3% [95% CI, 2.7% to 15.8%], P = .006). More gastrointestinal disorders were reported with liraglutide (3.0 mg) vs liraglutide (1.8 mg) and placebo. No pancreatitis was reported. CONCLUSIONS AND RELEVANCE: Among overweight and obese participants with type 2 diabetes, use of subcutaneous liraglutide (3.0 mg) daily, compared with placebo, resulted in weight loss over 56 weeks. Further studies are needed to evaluate longer-term efficacy and safety. TRIAL REGISTRATION: clinicaltrials.gov Identifier:NCT01272232.

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  1. [1]1. American Society for Metabolic and Bariatric Surgery, Obesity Society, American Society of Bariatric Physicians, American Association of Clinical Endocrinologists. Joint Press Release: Obesity Is a Disease: Leading Obesity Groups Agree. PRNewswire website. http://www.prnewswire.com /news-releases/obesity-is-a-disease-leading -obesity-groups-agree-212194851.html. 2013. Accessed June 4, 2015.

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Metadata

Authors
Davies, M. J., Bergenstal, R., Bode, B., Kushner, R. F., Lewin, A., Skjøth, T. V., Andreasen, A. H., Jensen, C. B., DeFronzo, R. A., & for the NN8022-1922 Study Group
Affiliations
  • University of Leicester (GB)
  • Park Nicollet Health Services (US)
  • Atlanta Diabetes Associates (US)
  • Northwestern University (US)
  • National Research Institute (US)
  • Novo Nordisk (Denmark) (DK)
  • Texas Diabetes Institute (US)
Venue
JAMA
Published
2015-08-18
Volume
314
Issue
7
Pages
687
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
OpenAlex
W1798757189
Cited by
1,198
References
29
Citations by year
2026: 121 · 2025: 188 · 2024: 152 · 2023: 141 · 2022: 94 · 2021: 114 · 2020: 74 · 2019: 67 · 2018: 78 · 2017: 74 · 2016: 83 · 2015: 11
FWCI
59.16
Type
journal article
Language
en
Open access
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
  • Leicester Research Archive (University of Leicester) (acceptedVersion)
  • Figshare (submittedVersion, cc-by)
Funders
  • Amgen
  • Bristol-Myers Squibb
  • Eli Lilly and Company
  • Pfizer
  • AstraZeneca
  • GlaxoSmithKline
  • Sanofi
  • Gilead Sciences
  • Leona M. and Harry B. Helmsley Charitable Trust
  • MannKind Corporation
  • Halozyme
  • Dexcom
  • Zafgen
  • ResMed
  • Bayer HealthCare
  • Novo Nordisk
  • Servier
  • Bavarian Nordic
  • Esperion Therapeutics
  • National Institutes of Health
  • Abbott Diabetes Care
Topics
  • Health Sciences › Medicine › Pharmacology (medical) › Pharmacology and Obesity Treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Keywords
liraglutide, type 2 diabetes, weight loss, obesity, overweight, GLP-1 receptor agonists, physical activity, HbA1c, glycemic control, drug safety, adverse events, dose comparison, weight regain, body mass index
MeSH terms
Liraglutide, Adult, Aged, Body Weight, Diabetes Mellitus, Type 2, Diet, Reducing, Double-Blind Method, Female, Humans, Hypoglycemic Agents, Injections, Subcutaneous, Male, Middle Aged, Obesity, Weight Loss, Exercise, Glucagon-Like Peptide 1

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