The Real-World Use of Semaglutide to Promote Weight Loss in Obese Adults With Hemodialysis: A Multicenter Cross-Sectional Descriptive Study
Notice bibliographique
Résumé
Background: Obesity can be an issue for renal transplant eligibility. Semaglutide constitutes an interesting choice for obesity treatment, but little data exist regarding its efficacy and security among dialysis patients. Objectives: The co-primary endpoints of this study were to describe the change in body weight (%) and in body mass index (BMI) from the beginning and after 3, 6, and 12 months of treatment for participants who used semaglutide compared with a control group of non-users. Secondary endpoints included description of dosages used and reported adverse events. Design: Multicenter cross-sectional descriptive study. Setting: Seven hemodialysis centers in Quebec and New Brunswick, Canada. Patients: Adults receiving hemodialysis treatment with BMI of at least 30 kg/m 2 were included. Measurements: Weight as defined by the target body weight (kg) at the end of dialysis. Body mass index is defined by weight, kg/m 2 . Methods: As a primary objective, we collected in records the body weights and calculated BMI at months 0, 3, 6, and 12 for participants with BMI of 30 kg/m 2 or greater. The dosages of semaglutide and the mention of any adverse events were also collected from questionnaire to participants, to community drug stores, and from records. Results: A total of 1286 patients received hemodialysis treatments in June 2023. Of these, 396 (31%) had a BMI of 30 kg/m 2 or greater. Two hundred fifty-one participants were included in the study and 41 (16%) received semaglutide. The estimated treatment differences for the percentage change in body weight from baseline to 3, 6, and 12 months for semaglutide compared with the control group were −2.26%, 95% confidence interval (CI), −3.68 to −0.84, P = .002; −0.94%, 95% CI, −2.17 to 0.29, P = 0.135; and −0.64%; 95% CI, −2.04 to 0.76, P = .370, respectively. The estimated treatment differences at 3, 6, and 12 months for BMI were −0.87 kg/m 2 , 95% CI, −1.38 to −0.36, P < .001; −0.35 kg/m 2 , 95% CI, −0.79 to 0.09, P = .119; and −0.23 kg/m 2 , 95% CI, −0.72 to 0.27, P = .371, respectively. The estimated treatment difference in body weight and BMI change between the 2 groups was statistically significant at 3 months. A sensitivity analysis was carried out with all the participants of the semaglutide group who continued the treatment for 12 months (N = 15). The estimated treatment differences for the percentage change in body weight between this group and the control group were −3.04%, 95% CI, −5.18 to −0.89, P = .006; −1.97%, 95% CI, −3.79 to −0.14, P = .035; and −2.83%, 95% CI, −4.66 to −1.00, P = .003 at 3, 6, and 12 months, respectively. The average body weight change between months 0 and 12 was −3.88 ± 7.90 kg in the semaglutide group compared with −0.52 ± 5.53 kg in the control group ( P = .015). With the sensitivity analysis, the body weight change between Months 0 and 12 was −6.83 ± 6.90 kg for the participants who continued their treatment for 12 months. The dosage of 1 mg of semaglutide was the most prescribed (49%). The occurrence of adverse events led to dose reduction in 5 participants (12%) and to treatment discontinuation in 13 participants (32%). Limitations: This study has several limitations, including its non-randomized design, short follow-up period, small sample size, and incomplete data on treatment compliance and adverse effects. Differences in patient characteristics, limited semaglutide doses for weight loss, and declining sample sizes over time further reduce the strength of conclusions, necessitating cautious interpretation of group comparisons. Conclusions: This study suggests that semaglutide promotes weight loss in hemodialyzed adults with obesity, but discontinuation of treatment was frequent and common adverse events were reported.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».