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17 pages, 2123 KiB  
Article
Clinical Data Mega-Collection of Obesity and Obesity-Related Trials: Primary Inclusion Criteria from All Studies and Highlights of Clinical Efficacy Analysis of GLP-1 Drugs
by Trung Tin Nguyen and David R. Elmaleh
J. Clin. Med. 2025, 14(3), 812; https://doi.org/10.3390/jcm14030812 - 26 Jan 2025
Viewed by 2147
Abstract
Background/Objectives: Obesity is heterogeneous and considered a chronic epidemic with significant un-met needs for management, treatment, and prevention. Methods: In this study, we used LizAI’s software TAITAN (alpha version) for the mega-collection and analysis of clinical data from 10,407 trials addressing obesity and [...] Read more.
Background/Objectives: Obesity is heterogeneous and considered a chronic epidemic with significant un-met needs for management, treatment, and prevention. Methods: In this study, we used LizAI’s software TAITAN (alpha version) for the mega-collection and analysis of clinical data from 10,407 trials addressing obesity and obesity-related diseases and their associated publications, mainly on PubMed. Results: We report an intensive growth of clinical trials until the end of 2024 and highlight the use of the body mass index (BMI) as a critical criterion in clinical participant selection despite its limitations. The significant disparities in races, regions, and the sites of trials across all studies have not been addressed, posing the possibility of research in the far future on the applications of precision medicine in weight management. In the latter parts of this paper, we analyze and discuss the clinical efficacy, mainly focusing on the primary endpoints and benchmarks of the recently FDA-approved once-weekly injectable glucagon-like peptide-1 receptor agonist (GLP-1 RA) drugs, including semaglutide and tirzepatide. Both drugs have functioned comparably when considering the 5% weight loss FDA threshold. Tirzepatide outperforms semaglutide and impacts fewer participants as the weight loss level increases from 5 to 20% and has greater effects in different populations, especially in people with type 2 diabetes (T2D). Conclusions: We would, however, like to highlight that (i) the weight loss level should be dependent on the clinically relevant needs of patients, and faster and greater weight loss might not be a win, and (ii) the clinical benefits, safety, and quality of life of patients should be carefully assessed when the weight loss is significant in a short period. In our search, we found that the specificities and impacts of weight loss therapies on organs like the kidneys and heart, different muscle types, bones, and fat accumulation in different parts of body were not investigated or disclosed during the clinical study period and longer term monitoring. In light of scientific needs and remarkable public interest in weight loss, our report provides findings on the buzz around losing weight in clinical trials, and our TAITAN software continues to collect data in real time and enrich its knowledge for future updates. Full article
(This article belongs to the Special Issue Clinical Advances in the Management and Treatment of Obesity)
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15 pages, 1898 KiB  
Article
Subcutaneous Semaglutide during Breastfeeding: Infant Safety Regarding Drug Transfer into Human Milk
by Hanin Diab, Taylor Fuquay, Palika Datta, Ulrich Bickel, Jonathan Thompson and Kaytlin Krutsch
Nutrients 2024, 16(17), 2886; https://doi.org/10.3390/nu16172886 - 28 Aug 2024
Cited by 4 | Viewed by 21842
Abstract
Postpartum mothers and their healthcare providers often face the challenge of limited data regarding the safety of drug therapies during lactation. Pregnancy can lead to sustained weight gain, and obesity can negatively impact both physical and psychological well-being. The introduction of GLP-1 agonists [...] Read more.
Postpartum mothers and their healthcare providers often face the challenge of limited data regarding the safety of drug therapies during lactation. Pregnancy can lead to sustained weight gain, and obesity can negatively impact both physical and psychological well-being. The introduction of GLP-1 agonists to augment weight loss has become a topic of interest for many postpartum mothers. Our study aims to investigate the transmission of semaglutide into human milk in the first steps to ensure the safety and health of both lactating mothers and their breastfed infants. Semaglutide quantification was performed using high-resolution liquid chromatography-mass spectrometry. InfantRisk Center Human Milk biorepository released milk samples from eight women collected at 0, 12 and 24 h post-semaglutide administration. Semaglutide was extracted using protein precipitation in methanol, followed by chromatographic separation. Linear calibration curves for the method ranged between 2.5–30 ng/mL, with a limit of detection of 1.7 ng/mL and a limit of quantification of 5.7 ng/mL (LLOQ). Semaglutide was not detected in any of the collected human milk samples. A worst-case scenario of the relative infant dose (RID) was calculated using the LLOQ as the drug concentration in milk when considering semaglutide’s bioavailability and long-acting dose profile. The maximum RID projected was 1.26%, far below the standard 10% safety threshold. While questions about long-term infant outcomes, the safety of maternal nutrient intake, and the nutrient content of breast milk remain, our findings suggest that semaglutide concentrations in human milk are unlikely to pose clinical concerns for breastfed infants. These results support healthcare providers in making informed decisions regarding postpartum therapeutic interventions. Full article
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