Exenatide in obesity with accelerated gastric emptying: a randomized, pharmacodynamics study. Issue 10 (October 2015) - Acosta, Andres
Abstract: Obesity is associated with differences in satiety, gastric emptying (GE), gastric volume, and psychological traits. Exenatide, a short‐acting glucagon‐like peptide 1 (GLP‐1) receptor agonist, is associated with variable weight loss. We compared the effects of exenatide, 5 μ g, and placebo SQ, twice daily for 30 days on GE of solids and liquids (scintigraphy), satiety (ad libitum buffet meal), satiation (nutrient drink test, maximum tolerated volume [MTV]), and weight loss in 20 participants with documented accelerated GE of solids (T1/2 < 90 min). Exenatide delayed GE of solids (T1/2 [Δ] 86 min relative to placebo, P < 0.001) and reduced calorie intake at buffet meal ([Δ] 129 kcal compared to placebo). Median weight loss was −0.95 kg (IQR −0.7 to −2.1) for exenatide and −0.55 kg (0.3 to −2.1) for placebo ( P = 0.23); 80% of exenatide group had documented reduction in weight. In the exenatide treatment group, there was an inverse correlation between gastric emptying T1/2 and MTV ( R = −0.548, P = 0.089). The univariate association of weight change with posttreatment MTV was borderline ( R s = 0.43, P = 0.06); in the multiple regression model, posttreatment MTV was associated with weight change ( P = 0.047). The effect of the short‐acting GLP‐1 receptor agonist, exenatide, on GE is associated with the change in food intake, and the latter impacts weight loss in response to exenatide treatment. Abstract : Obesity is associated with differences in satiety, gastric emptying, gastric volume, and psychological traits. Exenatide, a short‐acting glucagon‐like peptide 1 (GLP‐1) receptor agonist, is associated with variable weight loss. In our study, exenatide delayed gastric emptying of solids and reduced calorie intake, thus impacting weight loss in response to exenatide treatment.