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Farmakologisk behandling vid fetma : Semaglutid versus liraglutid

Obesity is a health problem that is increasing worldwide and has high socioeconomic impact. In Sweden, obesity costs the society 70 billion SEK every year. For the year 2030, the Institute for Health and Medical Care Economics predicts that obesity can cost the society up to 17 billion SEK more than in 2018. In Sweden, 52% of the citizens 16-84 years of age are either overweight or obese.  The main factor behind obesity is still unidentified. What is known, and almost self-evident, is that weight gain occurs when energy consumption is lower than energy intake. The calorie intake during a day should be 1600-3000 calories and physical activity is important. For weight loss, the focus is mostly on calorie intake, but it is also important to consider the metabolic homeostasis which is regulated by hormones. Obesity can occur when there is a disturbance in the homeostatic mechanisms. One of the most important regulatory hormones is glucagon-like-peptide-1 (GLP-1) which stimulates satiety. Liraglutide and semaglutide are both GLP-1-analogues and are used in the treatment of type 2 diabetes. Liraglutide is also indicated in obesity and semaglutide as an anti-obesity drug has just undergone a phase 3 study. The mechanism of action of GLP-1-analogues in obesity is to stimulate a feeling of satiety, which leads to a lower energy intake and thus weight loss.  The aim of this thesis was to evaluate whether semaglutide can be used as an anti-obesity drug and the effect and safety of the substance compared with the already approved drug liraglutide.  The thesis is a literature study that uses five randomized clinical trials from the database PubMed. Of the six scientific articles, two examine liraglutide for 56 weeks, two semaglutide for 68 weeks and one both drugs for 52 weeks.  All studies demonstrate that semaglutide has a better effect on reducing body weight and waist measurement than liraglutide. In study 5, semaglutide above 1,4 mg per week is shown to have a statistically significantly better weight loss effect compared to liraglutide. Gastrointestinal side effects were the most common side effects in all included studies. The majority of these were of mild or moderate intensity. Of the gastrointestinal side effects, nausea was most common. In the semaglutide groups, the total side effects were slightly more frequent than in the liraglutide groups, which is mainly shown in study 5. Possible factors affecting the results is whether the participants receive IBT or lifestyle advice in combination with the treatment.  Conclusions that can be drawn from the studies is that semaglutide is more effective in terms of weight loss and reduction of waist measurements compared to liraglutide. The adverse reactions were generally similar between semaglutide and liraglutide. Semaglutide should currently be administered with caution and under supervision. More studies need to be conducted to control the dosage and safety.

Identiferoai:union.ndltd.org:UPSALLA1/oai:DiVA.org:lnu-101832
Date January 2021
CreatorsNilsson, Natalié
PublisherLinnéuniversitetet, Institutionen för kemi och biomedicin (KOB)
Source SetsDiVA Archive at Upsalla University
LanguageSwedish
Detected LanguageEnglish
TypeStudent thesis, info:eu-repo/semantics/bachelorThesis, text
Formatapplication/pdf
Rightsinfo:eu-repo/semantics/openAccess

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