Cited by 2,724Pharmacology and Obesity TreatmentDiabetes Treatment and ManagementRegulation of Appetite and Obesity

A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management

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Pi-Sunyer, Xavier, Astrup, Arne, Fujioka, Ken, Greenway, Frank, Halpern, Alfredo, Krempf, Michel, Lau, David C.W., le Roux, Carel W. +3 more·2015·New England Journal of Medicine

Abstract

BACKGROUND: Obesity is a chronic disease with serious health consequences, but weight loss is difficult to maintain through lifestyle intervention alone. Liraglutide, a glucagon-like peptide-1 analogue, has been shown to have potential benefit for weight management at a once-daily dose of 3.0 mg, injected subcutaneously. METHODS: We conducted a 56-week, double-blind trial involving 3731 patients who did not have type 2 diabetes and who had a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of at least 30 or a BMI of at least 27 if they had treated or untreated dyslipidemia or hypertension. We randomly assigned patients in a 2:1 ratio to receive once-daily subcutaneous injections of liraglutide at a dose of 3.0 mg (2487 patients) or placebo (1244 patients); both groups received counseling on lifestyle modification. The coprimary end points were the change in body weight and the proportions of patients losing at least 5% and more than 10% of their initial body weight. RESULTS: At baseline, the mean (±SD) age of the patients was 45.1±12.0 years, the mean weight was 106.2±21.4 kg, and the mean BMI was 38.3±6.4; a total of 78.5% of the patients were women and 61.2% had prediabetes. At week 56, patients in the liraglutide group had lost a mean of 8.4±7.3 kg of body weight, and those in the placebo group had lost a mean of 2.8±6.5 kg (a difference of -5.6 kg; 95% confidence interval, -6.0 to -5.1; P<0.001, with last-observation-carried-forward imputation). A total of 63.2% of the patients in the liraglutide group as compared with 27.1% in the placebo group lost at least 5% of their body weight (P<0.001), and 33.1% and 10.6%, respectively, lost more than 10% of their body weight (P<0.001). The most frequently reported adverse events with liraglutide were mild or moderate nausea and diarrhea. Serious events occurred in 6.2% of the patients in the liraglutide group and in 5.0% of the patients in the placebo group. CONCLUSIONS: In this study, 3.0 mg of liraglutide, as an adjunct to diet and exercise, was associated with reduced body weight and improved metabolic control. (Funded by Novo Nordisk; SCALE Obesity and Prediabetes NN8022-1839 ClinicalTrials.gov number, NCT01272219.).

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Crossref · 10.1056/nejmoa1411892

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  • Real-world pancreatitis rates of approximately 4 to 8 per 1000 person-years with GLP-1RA are several fold higher than in the major weight loss RCTs of liraglutide.

    “These real‐world pancreatitis rates of approximately 4 to 8 per 1000 person‐years with GLP‐1RA are several fold higher than in the major weight loss RCTs of liraglutide RCT. 17 , 18 , 19 , 26”

    From Real‐world evidence on the utilization, clinical and comparative effectiveness, and adverse effects of newer <scp>GLP</scp> ‐ <scp>1RA</scp> ‐based weight‐loss therapies (2025) · cites this paper as [17]

    The Side Effects and Adverse Events section (p. 8) reports 0.4 pancreatitis events per 100 patient-years in the liraglutide group, equivalent to 4 per 1000 patient-years. The cited trial rate is therefore equal to the low end of the stated real-world range of 4–8 per 1000, not several-fold lower. (LLM, conf=0.90)

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  • A 3 mg dose of liraglutide can result in an average weight loss of 5.6 kg over nearly one year in overweight or obese individuals without diabetes.

    “Previous large randomized clinical trials have demonstrated that a 3 mg dose of liraglutide can result in an average weight loss of 5.6 kg over nearly one year in overweight or obese individuals without diabetes [71].”

    From New Developments in Pharmacological Treatment of Obesity and Type 2 Diabetes—Beyond and within GLP-1 Receptor Agonists (2024) · cites this paper as [71]

    The Results (p. 1) report that the liraglutide group lost a mean of 8.4 kg at 56 weeks. The cited 5.6 kg is the difference in mean weight loss between the liraglutide and placebo groups, not the average loss among those receiving liraglutide. (LLM, conf=0.88)

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  • Liraglutide, the first incretin therapy approved by the U.S. Food and Drug Administration for obesity management in patients without diabetes, induced and maintained a modest 8% decrease in body weight over 56 weeks.

    “Liraglutide, the first incretin therapy approved by the U.S. Food and Drug Administration for obesity management in patients without diabetes, induced and maintained a modest 8% decrease in body weight over a period of 56 weeks (41).”

    From The Benefits of Exercise Training in Combination With Weight Loss Therapies (2025) · cites this paper as [41]

    The Body Weight results (p. 4) report a mean 8.0% weight loss with liraglutide after 56 weeks, and the Discussion (p. 10) says it was generally maintained while patients continued treatment. The paper describes liraglutide as a GLP-1 analogue studied in adults without diabetes, but our copy does not establish that it was the first incretin therapy FDA-approved for obesity management in that population. (LLM, conf=0.88)

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  • In the SCALE Phase 3 trial, liraglutide 3.0 mg produced mean weight reduction from baseline to week 56 of −8.0% versus −2.8% for placebo.

    “liraglutide, the first GLP- 1 RA approved for chronic weight management (in 2014) was shown in the SCALE Phase 3 trial to produce mean weight reduction from baseline to week 56, of − 8.0% with liraglutide 3.0 mg versus − 2.8% with placebo (last-observation-carried-forward imputation—LOCF) [3].”

    From New drugs for the treatment of obesity: do we need approaches to preserve muscle mass? (2025) · cites this paper as [3]

    The Body Weight results (p. 4) report mean weight loss at 56 weeks of 8.0% with liraglutide 3.0 mg versus 2.6%, not 2.8%, with placebo. Table 2 (p. 6) likewise gives −2.6% for placebo; its −2.8 figure is in kilograms. The paper discusses LOCF imputation, but that does not make the cited placebo percentage correct. (LLM, conf=0.94)

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  • It is common in obesity pharmacotherapy trials that more people in the placebo group are lost to follow-up than in the active treatment group.

    “It is common in obesity pharmacotherapy trials that more people in the placebo group are lost to follow-up than in the active treatment group.8,10,35”

    From Healthy weight loss maintenance with exercise, GLP-1 receptor agonist, or both combined followed by one year without treatment: a post-treatment analysis of a randomised placebo-controlled trial (2024) · cites this paper as [10]

    Trial Population (p. 3) reports that fewer placebo patients completed 56 weeks of treatment than liraglutide patients (64.4% versus 71.9%). This supports greater noncompletion in this trial, but it does not establish that the pattern is common across obesity pharmacotherapy trials. Study Procedures and End Points (p. 2) also says early withdrawers were asked to return at week 56, so treatment noncompletion is not necessarily loss to follow-up. (LLM, conf=0.87)

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Research works printed but not linked: 4

  1. [7]7. Jensen MD, Ryan DH, Donato KA, et al. Executive summary: guidelines (2013) for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Obesity Society published by the Obesity Society and American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Based on a systematic review from the Obesity Expert Panel, 2013. Obesity (Silver Spring) 2014; 22: Suppl 2: S5-S39.
  2. [2]2. Workgroup on Hypoglycemia. Diabetes Care 2005; 28: 1245-9.
  3. [14]14. International Conference on Harmonisation Expert Working Group. ICH harmonised tripartite guideline: guideline for good clinical practice (http://www .ich .org/ fileadmin/ Public\_Web\_Site/ ICH\_Products/ Guidelines/ Efficacy/ E6/ E6\_R1\_Guideline .pdf).
  4. [29]29. National Academy of Sciences. The prevention and treatment of missing data in clinical trials. Washington, DC: National Academies Press, 2010.

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Authors
Pi-Sunyer, X., Astrup, A., Fujioka, K., Greenway, F., Halpern, A., Krempf, M., Lau, D. C. W., le Roux, C. W., Violante Ortiz, R., Jensen, C. B., & Wilding, J. P. H.
Affiliations
  • University College Dublin (IE)
  • University of Copenhagen (DK)
  • Scripps Clinic (US)
  • Pennington Biomedical Research Center (US)
  • Universidade de São Paulo (BR)
  • Centre Hospitalier Universitaire de Nantes (FR)
  • University of Calgary (CA)
  • Novo Nordisk (Denmark) (DK)
  • University of Liverpool (GB)
Venue
New England Journal of Medicine
Published
2015-07-02
Volume
373
Issue
1
Pages
11-22
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W807162506
Cited by
2,724
References
31
Citations by year
2026: 353 · 2025: 450 · 2024: 399 · 2023: 316 · 2022: 209 · 2021: 234 · 2020: 160 · 2019: 145 · 2018: 145 · 2017: 140 · 2016: 140 · 2015: 31
FWCI
109.67
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
  • HAL (submittedVersion)
  • CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion, other-oa)
  • Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
  • Florence Research (University of Florence) (submittedVersion)
  • Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (P30DK026687)
Topics
  • Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
Keywords
liraglutide, obesity, weight loss, GLP-1 receptor agonists, lifestyle modification, prediabetes, adverse events, nausea, diarrhea, drug safety, weight management, subcutaneous injection, dyslipidemia, type 2 diabetes prevention, long-term weight maintenance, body mass index
MeSH terms
Liraglutide, Adult, Blood Glucose, Combined Modality Therapy, Counseling, Diarrhea, Diet, Reducing, Double-Blind Method, Female, Humans, Hypoglycemic Agents, Injections, Subcutaneous, Male, Middle Aged, Nausea, Obesity, Weight Loss, Exercise, Body Mass Index, Glucagon-Like Peptide 1

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