Liraglutide and weight loss

by Dr Robin Chung, chair of PWSA UK's Research Working Group

Our PWS community may have heard about a recent development regarding a diabetes drug called liraglutide (Saxenda). This is a diabetes drug given by injection and part of a group of drugs called “GLP1 analogues”, but it has recently been featured in the news media as a NICE-approved NHS drug to promote weight loss of around 5 to 10% body weight in non-diabetic people. This drug can be obtained via your NHS chemist after a brief online prescription consultation and does not require a GP face to face visit. There is a similar drug called semaglutide which has also shown excellent weight loss (15 – 20% body weight) in obese non-diabetic patients. Both liraglutide and semaglutide are NHS/NICE-approved for weight loss via specialist weight loss clinics, but liraglutide is now available on a less restrictive, but still prescription basis, via your local chemist. The drive to increase access to liraglutide is part of the Government’s renewed emphasis on addressing obesity as a public health problem, and the trickle down effect is exciting for PWS community… however…

There are some important considerations before we all rush out to our local chemist:

• The drug liraglutide (and also semaglutide) is not currently approved for use in PWS.
• Liraglutide is available for non-diabetic people who have an increased body mass index (BMI) of more than 30 to 35 kg/m². The normal BMI ranges from 17 to 25.
• There is a research study specific for liraglutide in PWS – this has not yet been published. Depending on those results, the situation for liraglutide in PWS may change, but we should wait until we have formal publication and UK medicines regulatory body advice.
• Liraglutide can have adverse side effects – the most important side effect relevant to PWS is related to the digestive (gastro-intestinal) system. Liraglutide slows digestion by delaying stomach (gastric) emptying, which may be undesirable in PWS.
• Common side effects with liraglutide include nausea (39% of people), diarrhoea (20%), vomiting (16%), low blood sugar (23% in diabetics), constipation (20%), headache (14%), decreased appetite (10%), gastric side effects (5%), and rarely (<1%) pancreatitis and very rarely thyroid (papillary) cancer and increased thyroid c-cell production.

The NICE press release can be found here.

The bottom line is that liraglutide is a promising weight loss drug now available via your local chemist after an online prescription consultation for use in non-diabetic people, but not approved in PWS. Therefore, our advice is to wait until the results of the PWS-Liraglutide specific study are available.



PWS DRUG TRIALS IN THE UK

There are potentially two international PWS drug trials that may open to our PWS community in the UK this year. PWSA UK will keep you posted regarding these exciting developments!