Preliminary observations on the administration of a glucagon-like peptide-1 receptor agonist on body weight and select carbohydrate endpoints in persons with spinal cord injury: A controlled case series.

Context/objective: To describe the effect of semaglutide, a glucagon-like peptide-1 (GLP-1) agonist, to reduce body weight and improve glycemic control in overweight or obese individuals with spinal cord injury (SCI).

Design: Open-label, randomized drug intervention case series.

Setting: This study was performed at James J. Peters VA Medical Center (JJP VAMC) and Kessler Institute for Rehabilitation (KIR).

Participants: Five individuals with chronic SCI meeting criteria for obesity and abnormal carbohydrate metabolism.

Intervention: Administration of semaglutide (subcutaneously once per week) versus no treatment (control) for 26 weeks.

Outcome measures: Change in total body weight (TBW), fat tissue mass (FTM), total body fat percent (TBF%), and visceral adipose tissue volume (VAT_vol) was determined at baseline and after 26 weeks using Dual energy X-ray absorptiometry; fasting plasma glucose (FPG) concentration and serum glycated hemoglobin (HbA1C) values were obtained at the same two time points.

Results: In 3 participants, after 26 weeks of semaglutide administration, TBW, FTM, TBF%, and VAT_vol decreased, on average, by 6, 4.4 kg, 1.7%, and 674 cm³, respectively. In addition, values for FPG and HbA1c decreased by 17 mg/dl and 0.2%, respectively. After 26 weeks of observation in the 2 control participants, TBW, FTM, TBF% and VAT_vol increased on average by 3.3 , 4.5 kg, 2.5%, and 991 cm³, respectively. The average values for FPG and HbA1c also increased by 11 mg/dl and 0.3%, respectively.

Conclusions: Administration of semaglutide for 26 weeks resulted in favorable changes in body composition and glycemic control, suggesting a reduced risk for the development of cardiometabolic disease in obese individuals with SCI.Trial registration: ClinicalTrials.gov identifier: NCT03292315.