Efficacy of CagriSema for Reaching Anthropometric Treatment Targets and Cardiometabolic Outcomes: A Secondary, Post hoc Analysis of REDEFINE 1.
CagriSema showed a higher percentage of participants achieving BMI and WHtR targets compared to other treatments, but the clinical significance of these findings requires further investigation.
Where it sits
this study against the rest of the cagrilintide (am833) corpusSummary and findings
This study evaluated the efficacy of CagriSema in achieving anthropometric treatment targets and cardiometabolic outcomes in adults with obesity. Participants received a dose of 2.4 mg of CagriSema weekly over 68 weeks. The study found that 30.3% of participants achieved both BMI < 27 kg/m² and WHtR < 0.53 with CagriSema compared to lower percentages in other treatment groups.
Abstract
<h4>Aims</h4>To assess the added value of absolute anthropometric targets alongside percentage weight loss in the clinical management of obesity.<h4>Materials and methods</h4>The phase 3a, 68-week REDEFINE 1 trial randomised adults without diabetes with BMI ≥ 30 kg/m<sup>2</sup>, or ≥ 27 kg/m<sup>2</sup> with ≥ 1 obesity-related complication, to once-weekly CagriSema 2.4 mg/2.4 mg, semaglutide 2.4 mg, cagrilintide 2.4 mg, or placebo, plus lifestyle intervention. This secondary, post hoc analysis assessed the proportions of participants achieving BMI < 27 kg/m<sup>2</sup> and/or WHtR < 0.53 targets, and percentage weight loss by anthropometric target. The association between the proportion of participants maintaining or achieving normalisation of four cardiometabolic outcomes: normoglycemia (glycated haemoglobin < 5.7% and fasting plasma glucose < 5.6 mmol/L); blood pressure (< 130/80 mmHg); triglycerides (< 1.7 mmol/L); lipids (high-density lipoprotein cholesterol ≥ 1.3 mmol/L [female] or ≥ 1.0 mmol/L [male]) and reaching anthropometric targets or change in body weight (%) was also assessed.<h4>Results</h4>The proportion of participants achieving both BMI < 27 kg/m<sup>2</sup> and WHtR < 0.53 targets at week 68 was 30.3%, 19.1%, 9.0%, and 3.3% in participants who received CagriSema, semaglutide, cagrilintide, or placebo respectively. Both BMI and WHtR performed similarly as indicators for all four cardiometabolic outcomes. At more stringent cut-off values, anthropometric targets were better measures than percentage weight loss.<h4>Conclusions</h4>The proportion of participants achieving anthropometric targets was greater with CagriSema Versus other treatments. These findings support further validation of BMI and WHtR anthropometric treatment targets and indicate a potential for indicating amelioration of clinical outcomes in obesity and a greater emphasis on target-based treatment strategies.
Background
This paper addresses the efficacy of CagriSema in achieving specific anthropometric targets and its association with cardiometabolic outcomes in individuals with obesity. Prior research has established the importance of weight loss in obesity management, but the role of specific anthropometric targets like BMI and waist-to-height ratio (WHtR) remains less clear. This study aims to clarify the added value of these targets in clinical practice.
Methods
The study is a secondary analysis of the phase 3a REDEFINE 1 trial, which randomized adults with a BMI ≥ 30 kg/m² or ≥ 27 kg/m² with obesity-related complications to receive either CagriSema 2.4 mg/2.4 mg, semaglutide 2.4 mg, cagrilintide 2.4 mg, or placebo, alongside lifestyle intervention. The primary outcomes assessed were the proportions of participants achieving BMI < 27 kg/m² and WHtR < 0.53 at 68 weeks.
Results
At week 68, the proportion of participants achieving both BMI < 27 kg/m² and WHtR < 0.53 was 30.3% for CagriSema, 19.1% for semaglutide, 9.0% for cagrilintide, and 3.3% for placebo. The study did not report p-values or confidence intervals for these findings. The analysis also indicated that anthropometric targets were better measures than percentage weight loss at more stringent cut-off values.
Interpretation
The findings suggest that CagriSema may be more effective than other treatments in achieving specific anthropometric targets, but the clinical significance of these results is uncertain without reported effect sizes or confidence intervals. The lack of detailed sample sizes and the nature of the post hoc analysis may limit the robustness of the conclusions. Further studies are needed to validate these findings and their implications for obesity management.
Key findings
- 30.3% achieved BMI < 27 kg/m² and WHtR < 0.53 with CagriSema at week 68, n=not reported, p=not reported.
- 19.1% achieved the same targets with semaglutide, n=not reported, p=not reported.
- 9.0% achieved the same targets with cagrilintide, n=not reported, p=not reported.
- 3.3% achieved the same targets with placebo, n=not reported, p=not reported.
Limitations
- This is a secondary, post hoc analysis.
- Sample sizes for each treatment group are not reported.
- No p-values or confidence intervals provided.
- Potential bias from post hoc analysis.