The drug for the treatment of type 2 diabetes Saxenda (liraglutide) has recently been approved by the FDA for weight loss.

It became the fourth drug, which was approved in the United States for the treatment of obesity since 2012.

Saxenda, as well as its "colleague" with a lower dosage of Victoza, is administered daily.

It is approved for use in patients with a body mass index of 30 and above that is considered obese, as well as in patients with a BMI of 27 if they have obesity-related serious illnesses such as hypertension.

It is believed that liraglutide should be used together with exercise and diet.

The medical edition WebMD asked two experts about how it actually works liraglutide for obesity.

How does the new drug reduce body weight?.

"Liraglutide is masked for glucagon-like peptide GLP-1 - a hormone that is produced by the intestine. One of the functions of GLP-1 is to inform the brain that the body is full, "explains Dr. William Troy Donahoo, an expert on obesity from Kaiser Permanente in Denver.

This drug has many mechanisms of action that help beta cells of the pancreas normalize blood sugar levels. Beta cells produce insulin, and liraglutide helps them in this.

How effective is liraglutide?.

Dr. Donahue says that he expects different results in terms of reducing body weight from taking Saxenda, as when using Victoza in diabetes, the effectiveness also varied greatly.

Clinical trials of Saxenda lasted about 1 year and included a total of 4,800 patients. The trials were randomized placebo-controlled, that is, some patients received a placebo.

"Clinical trials have shown that more than 60% of patients who received 3 mg of drug per day lost at least 5% of their original body weight, and in 31% of patients, body weight decreased by 10%. For comparison, on placebo for the same period in 34% of patients, body weight decreased by 5% and more. This is not an impressive weight loss for an injectable and expensive drug with many potentially serious side effects, "admits Dr. Osama Hamdy, director of the obesity program at the Joslin Diabetes Center.

How does liraglutide look like against other drugs?.

Saxenda was not compared directly with other weight loss drugs, such as those prescribed in the US Belviq, Contrave or Qsymia. Based on data from clinical studies, Dr. Donahue suggests that the new drug "will probably be worse than Qsymia, but better than Belviq".

The doctor adds that most patients prefer to take pills, so weight loss injections will be a serious obstacle, because of which they can refuse treatment.

Dr. Hamdi agrees with his colleague: "I will be surprised if someone wants to take a drug for weight loss in the form of injections. This drug (Saxenda) came out too late, and patients may not have the enthusiasm for such treatment ".

What are the main side effects of liraglutide?.

In clinical trials, patients often had nausea, but doctors say that sometimes it was unbearable and made them refuse to continue therapy.

In addition to nausea, the FDA reports other side effects: vomiting, diarrhea, constipation, hypoglycemia (lowering blood sugar levels), increased appetite. Serious side effects include: pancreatitis, cholelithiasis, impaired renal function, suicidal ideation, tachycardia.

In the instructions to the drug will be placed a warning about tumors of the thyroid gland. People who have certain types of thyroid cancer in the genus should not take liraglutide.

The FDA said that the agency will continue to study the safety of the drug. Particular attention will be paid to the risk of thyroid and breast cancer in post-marketing studies. The effect of Saxenda on the functioning of the nervous system in children is discussed.

How long does it take to take liraglutide for weight loss?.

Experts say that they can not give an accurate answer, because the clinical trials of the drug lasted only 1 year. The FDA claims that patients should be screened every 16 weeks of drug treatment. If the patient for 16 weeks lost less than 4% of body weight, treatment is considered ineffective, and should be stopped.

How will the drug affect the level of sugar?.

"The drug will affect the level of sugar only if you initially increased sugar, or if you take it with other hypoglycemic drugs," says Dr. Donahue.

When will Saxenda appear in pharmacies, and how much will it cost?.

Novo Nordisk, which distributes the drug in the US, expects its appearance in pharmacies in early 2015. The price, according to the representative of the company, has not yet been established. Novo Nordisk is negotiating with several insurance companies about the terms of coverage of the cost of medicine.

In Russia, liraglutide is sold under the brand name of Victoria, and approved for the treatment of diabetes mellitus.

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