Efficacy and tolerability of once-weekly subcutaneous semaglutide for weight management: A prospective follow-up study from Bangladesh

Background: Semaglutide is a well-known drug for long-term weight management but its efficacy and side effects are not well documented in a prospective follow-up study in Bangladesh. Objective: To assess weight-reducing efficacy and side effects of once-weekly subcutaneous Semaglutide at different doses with 3 months follow-up. Methods: Subjects with obesity, intended to lose weight, and having no contraindication of Semaglutide were included in the study. Semaglutide 0.25mg was introduced for the first 4 weeks followed by 0.5mg, and 1.0mg on subsequent follow-up based on tolerability and side effects. Clinical parameters were recorded at baseline and each follow-up. Face-to-face interviews were taken and possible side effects at different doses were recorded in a structured data collection sheet. Results: This preliminary report, included 22 patients (19 females [86.4%]; mean [SD] age, 32.8[8.1] years; mean [SD] BMI, 34.7[3.9]). On monthly follow-up in the 1st, 2nd, and 3rd months, follow-up completed 22, 17, and 13 patients respectively. Mean weight loss from baseline at 1st, 2nd, and 3rd follow-ups were 3.5±1.6 (2.8-4.3); 7.1±2.2 (6.0-8.3); 10.3±1.7 (9.2-11.3), 95% CI; p<0.0001, respectively. About 86.4% of the study population lost ≥10% of initial body weight at 3rd Follow-up. Regarding side effects, 50.0%, 64.7%, and 92.3% of patients reported any side effects; 4.5%, 5.9%, and 23.1% of patients developed serious side effects at a mean dose of 0.25, 0.5, and 1.0mg during follow-up. Most of the side effects were GIT origin, commonly anorexia, nausea, vomiting, diarrhea, and acid reflux. While a significant proportion (30.7%) of patients reported hair fall on 1.0mg Semaglutide. Among the major side effects, two patients developed hypoglycemia (DM=1, non-DM=1), and one developed cholelithiasis. No mortality was reported during the follow-up. Conclusions: The use of Semaglutide was associated with significant weight loss, however; side effects were the main obstacle in dose optimization.