Weight change from incretin-based weight loss medications across categories of second-generation antipsychotics.

IF 3.8 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

International Journal of Obesity Pub Date : 2025-08-15 DOI:10.1038/s41366-025-01885-4

Jithin Sam Varghese, David R Goldsmith, Robert O Cotes, Vishnu Ravikumar, Mohammed K Ali, Francisco J Pasquel

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引用次数: 0

Abstract

Objective: Patients prescribed second-generation antipsychotics (SGA) are at risk of antipsychotic induced weight gain (AIWG). The objective was to estimate weight changes after prescription of incretin-based weight loss medications by category of expected AIWG: high (olanzapine, clozapine), intermediate (risperidone, quetiapine, paliperidone) and low (e.g., asenapine, aripiprazole).

Methods: We conducted a retrospective cohort study using electronic health records (June 2021-December 2023) from Epic Cosmos for adults (≥18 years) without diabetes, prescribed SGA, and eligible for incretin-based weight loss medications. We studied changes in weight (kg) and the probability of at least 5% weight loss after 6 months of prescription of incretin-based medications by categories of AIWG.

Results: The analytic sample (n = 66,574) were aged 51.9 years (SD: 17.7), with average BMI of 39.5 kg/m² (SD: 7.7). Those prescribed incretin-based medications lost -2.17 kg (95% CI: -2.49, -1.84), and were 1.71 (95% CI: 1.63, 1.80) times more likely to achieve 5% weight loss, relative to those who didn't receive prescriptions. Weight loss was greater among those prescribed SGAs of low AIWG (-3.02 kg, 95% CI: -3.29, -2.74), relative to those prescribed high AIWG (-1.33 kg, 95% CI: -2.04, -0.62).

Conclusions: Semaglutide and tirzepatide induce weight loss among those prescribed SGAs, with lower effectiveness in those prescribed higher AIWG SGAs.

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以肠促胰岛素为基础的减肥药在第二代抗精神病药类别中的体重变化。

目的：服用第二代抗精神病药物（SGA）的患者存在抗精神病药物诱导体重增加（AIWG）的风险。目的是根据预期的AIWG类别估计肠促胰岛素减肥药处方后的体重变化：高（奥氮平，氯氮平），中等（利培酮，喹硫平，帕利哌酮）和低（如阿塞那平，阿立哌唑）。方法：我们使用Epic Cosmos的电子健康记录（2021年6月至2023年12月）进行了一项回顾性队列研究，对象为无糖尿病、处方SGA、符合肠促胰岛素减肥药条件的成人（≥18岁）。我们研究了按AIWG分类的肠促胰岛素类药物处方6个月后体重（kg）的变化和体重减轻至少5%的可能性。结果：分析样本（n = 66,574）年龄为51.9岁（SD: 17.7），平均BMI为39.5 kg/m2 （SD: 7.7）。那些服用以肠内分泌素为基础的药物的人减掉了-2.17公斤（95% CI: -2.49, -1.84），与那些没有服用处方的人相比，体重减轻5%的可能性是1.71倍（95% CI: 1.63, 1.80）。相对于高AIWG组（-1.33 kg, 95% CI: -2.04, -0.62），低AIWG组减重更大（-3.02 kg, 95% CI: -3.29, -2.74）。结论：西马鲁肽和替西帕肽在服用SGAs的患者中可诱导体重减轻，但在服用高AIWG SGAs的患者中效果较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Obesity 医学-内分泌学与代谢

CiteScore

10.00

自引率

2.00%

发文量

221

审稿时长

3 months

期刊介绍： The International Journal of Obesity is a multi-disciplinary forum for research describing basic, clinical and applied studies in biochemistry, physiology, genetics and nutrition, molecular, metabolic, psychological and epidemiological aspects of obesity and related disorders. We publish a range of content types including original research articles, technical reports, reviews, correspondence and brief communications that elaborate on significant advances in the field and cover topical issues.