Real-World Efficacy and Safety of Setmelanotide in Adults With Monogenic or Syndromic Obesity: A Prospective Cohort Study

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity Pub Date : 2025-09-02 DOI:10.1002/oby.70002

Francois Mifsud, Sarah Chalopin, Emilie Guillon, Pauline Faucher, Jean Muller, Johanne Le Bihan, Karine Clément, Christine Poitou

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引用次数: 0

Abstract

Objective

The melanocortin-4 receptor agonist setmelanotide has demonstrated effectiveness in phase 3 clinical trials for patients with monogenic obesity caused by biallelic variants in the leptin receptor (LEPR) and pro-opiomelanocortin (POMC), as well as for individuals with Bardet–Biedl syndrome (BBS). However, real-world evidence remains limited. This study evaluates the long-term effectiveness and safety of setmelanotide in patients who received treatment under a pre-marketing early-access authorization.

Methods

This ongoing prospective monocentric cohort includes 17 patients with obesity due to BBS (n = 11) or biallelic variants in LEPR (n = 4) or POMC (n = 2) who either started setmelanotide in routine care between 2022 and 2024 or continued therapy after participating in the RM-493-022 clinical trial. The average follow-up time was 14.4 months.

Results

Patients experienced a clinically significant weight reduction of 20% from their highest pre-treatment weight within the first year. Those previously treated in a clinical trial maintained their weight loss over time. Additionally, eating behavior improved, with significant reductions in hunger (−62%), food craving (−41%), and external eating evaluated by DEBQ. The overall safety profile was consistent with phase 3 trials data, without any new safety signals.

Conclusions

These findings confirm the drug's long-term clinical benefit and safety profile in a routine-care setting.

Abstract Image

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赛特美拉肽治疗成人单基因或综合征性肥胖的实际疗效和安全性：一项前瞻性队列研究。

目的：黑素皮素-4受体激动剂setmelanotide在3期临床试验中证明了对由瘦素受体（LEPR）和前opiomelanocortin （POMC）双等位基因变异引起的单基因肥胖患者以及baret - biedl综合征（BBS）患者的有效性。然而，真实世界的证据仍然有限。本研究评估了setmelanotide在上市前早期获得许可接受治疗的患者中的长期有效性和安全性。方法：这项正在进行的前瞻性单中心队列研究包括17例因BBS （n = 11）或LEPR （n = 4）或POMC （n = 2）双等位基因变异而肥胖的患者，这些患者要么在2022年至2024年期间在常规护理中开始setmelanotide，要么在参加RM-493-022临床试验后继续治疗。平均随访时间14.4个月。结果：患者在第一年内经历了临床显著的体重减轻，比治疗前的最高体重减少了20%。那些先前在临床试验中接受治疗的人随着时间的推移保持了体重下降。此外，饮食行为得到改善，饥饿感（-62%）、食物渴望（-41%）和外部进食（DEBQ评估）显著减少。总体安全性与3期试验数据一致，没有任何新的安全信号。结论：这些发现证实了该药在常规护理环境中的长期临床获益和安全性。

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来源期刊

Obesity 医学-内分泌学与代谢

CiteScore

11.70

自引率

1.40%

发文量

261

审稿时长

2-4 weeks

期刊介绍： Obesity is the official journal of The Obesity Society and is the premier source of information for increasing knowledge, fostering translational research from basic to population science, and promoting better treatment for people with obesity. Obesity publishes important peer-reviewed research and cutting-edge reviews, commentaries, and public health and medical developments.