According to a recent Danish cohort study, nearly half of adults who initiated semaglutide (Wegovy) for obesity management discontinued treatment within a year.
Discontinuation Rates
Among 157,822 first-time semaglutide users without diabetes, 49% stopped treatment by 12 months, indicated by a prescription gap of 60 days or more. The discontinuation rates increased steadily, starting from 13% by 3 months, reaching 27% by 6 months, and 39% by 9 months.
Restarting Therapy
Interestingly, one in four individuals who discontinued therapy resumed treatment within 3 months, as reported by Aurélie Mailhac, MSc, from Aarhus University Hospital, in the journal JAMA Network Open.
Risk Factors for Discontinuation
The study highlighted that the discontinuation of semaglutide within the first year is significant, with no identifiable subgroup less likely to cease treatment. The discontinuation risk remained 41% or higher across all groups, stratified by baseline characteristics, including younger individuals aged 18-29, men compared to women, and individuals residing in low-income municipalities.
Associated Health Issues
Higher discontinuation rates were observed among those with:
- Prior psychiatric medication use: RR 1.13
- Prior gastrointestinal medication use: RR 1.10
- Kidney disease: RR 1.09
- Cardiovascular disease: RR 1.08
- Prediabetes: RR 1.05
- Metabolic syndrome: RR 1.02
Mailhac suggested that these findings may indicate financial barriers to long-term therapy and increased susceptibility to adverse effects in certain populations. Younger individuals and those with socioeconomic disadvantages may find it challenging to afford the medication over the long term.
Concerns About Early Discontinuation
These observations raise concerns as they suggest that those who may benefit most from semaglutide for obesity management are the ones most likely to discontinue treatment prematurely. Others might have achieved their weight loss goals or viewed semaglutide as a transient therapy for acquiring healthier habits.
Importance of Continuous Support
It is crucial to provide adequate support from the outset to assist patients in staying on track. This includes discussing personal motivations, long-term costs, ongoing lifestyle guidance, tailored dosage adjustments, and monitoring for side effects effectively.
Future Considerations
The nationwide cohort study involved Danish adults who began semaglutide for obesity from December 2022 to November 2024. The study recorded a median age of 49 years, with 69% being female. Limitations include a lack of post-initiation weight-loss data and insufficient income and insurance coverage details.
Although the findings may not fully apply to other countries, similar high discontinuation rates have been observed in the U.S. across various obesity management medications, influenced by factors such as drug pricing and insurance coverage.
Disclaimer: This content is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
Fuente: https://www.medpagetoday.com/endocrinology/obesity/122808
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