Differences in weight loss and safety between the glucagon-like peptide-1 receptor agonists: A non-randomized multicenter study from the titration phase.

INTRODUCTION: Obesity increases the risk of type 2 diabetes mellitus and cardiovascular disease (CVD). Weight loss (≥5 %) reduces the risk of CVD. Glucagon-like peptide-1 receptor agonists (GLP1 RA) have shown clinically weight loss. OBJECTIVES: 1) To assess differences in the efficacy of weight loss and HbA1c; 2) to evaluate the safety and adherence during the titration phase. METHODS: It is a multicenter, prospective, and observational study on GLP1 RA naïve patients. The primary end point was the weight loss (≥5 %). Changes in weight, BMI and HbA1c were also calculated as co-primary endpoints. Secondary endpoints were safety, adherence, and tolerance. RESULTS: Among 94 subjects, 42.4 % received dulaglutide, 29,3 % subcutaneous semaglutide, 22,8 % oral semaglutide. 45 % female and the mean age was 62. Baseline characteristics were body weight 99.3 kg, BMI 36.7 kg/m2 and Hba1c 8.2 %. Oral semaglutide achieved the highest reduction: 61.1 % of patients achieving ≥ 5 %, subcutaneous semaglutide 45.8 % and dulaglutide 40.6 %. GLP1 RA significantly reduced body weight (-4.95 kg, p < 0.001) and BMI (-1.86 kg/m2, p < 0.001), without significant differences between groups. Gastrointestinal disorders were the most frequently reported events (74.5 %). 62 % of patients on dulaglutide, 25 % on oral semaglutide and 22 % on subcutaneous semaglutide. CONCLUSIONS: Oral semaglutide achieved the highest proportion of patients that lost ≥ 5 %. GLP1 RA significantly reduced BMI and HbA1c. Most of the reported adverse events were gastrointestinal disorders and they were reported in a major frequency in the dulaglutide group. Oral semaglutide would be a reasonable switch in case of future shortages.

La edad de inicio en el consumo de drogas, un indicador de consumo problemático / The starting age of drugs consumption as an indicator for problematic consumption

En este trabajo se estudia la relación entre el inicio precoz de consumo de tabaco, alcohol y cannabis y los consumos problemáticos, en una muestra de 6280 jóvenes madrileños, entre 15 y 24 años. La experimentación temprana con tabaco, alcohol (antes de los 14 años) o cannabis (antes de los 15 años) se asocia a prevalencias mas elevadas de consumo diario de tabaco y de cannabis, a patrones de alcohol abusivo en promedio diario y a policonsumo regular o consumo concurrente de 2 o más drogas en el último mes. También se asocia con consecuencias negativas provocadas por el consumo de alcohol o drogas en el ámbito académico, económico, familiar y social. Se observa que la fuerza de las asociaciones encontradas aumenta a medida que aumenta el número de sustancias de inicio precoz, resultando esto una constante en la práctica totalidad de las asociaciones estudiadas, lo que sugiere que seria interesante incorporar en estudios futuros el análisis de inicios precoces de consumos agrupados (AU)

Our research’s aim consists on studying the relationship between early beginning of tobacco, alcohol and drugs taking, and problematic consumption, in a sample of 6280 young people from Madrid in a range of 15-24 years old. The early experimentation with tobacco, alcohol (before 14 years old) or cannabis (before 15 years old) is related to a higher prevalence of daily tobacco and cannabis consumption, to a daily alcohol-abusive patterns and to either regular multiple-drugs consumption or concurrent consumption of 2 or more drugs in the last month. It has been found too an association with negative consequences caused by alcohol and drugs consumption in economic, academic, and family life. This research reveals that the strength of these kinds of associations increases with the number of consumed substances very early. In fact, that happens in almost all the analyzed associations, and this is the reason of our suggestion of including an analysis of precocious starting of gathered consumptions in future researches (AU)