Magnitude and Determinants of Weight Loss Response to GLP-1/GIP Receptor Agonists in India: A Real-World Time-to-Event Analysis.

INTRODUCTION

Obesity and type 2 diabetes (T2D) are rapidly increasing in India. Although newer glucagon-like peptide/glucose-dependent insulinotropic polypeptide (GLP-1/GIP) receptor agonists have demonstrated considerable efficacy in weight loss, real-world evidence from the Indian population is lacking. This study evaluated the response to semaglutide and tirzepatide in overweight/obese individuals in routine clinical practice.

METHODS

This retrospective cohort study was conducted at a tertiary centre in New Delhi, India. Data from 150 overweight/obese participants (74 with T2D, 76 without T2D) treated with semaglutide/tirzepatide over 6 months were analysed. Outcomes included percentage weight loss, achievement of predefined weight-loss thresholds, time-to-event (≥10% weight loss), and determinants of time-to-event. Non-parametric tests and Cox proportional hazard regression were used for analysis.

RESULTS

The median weight loss was 8.2% (4.93-13.66). Participants without T2D achieved significantly greater weight loss than those with T2D (11.21% vs 5.48%, P < 0.001). Tirzepatide was associated with greater weight loss compared with semaglutide (8.60% vs 5.62%, P = 0.023). Sixty-two participants (41.3%) achieved a weight loss of ≥10%, with a median time-to-event of 9.5 months. Multivariable analysis identified younger age, tirzepatide use, and GLP1 treatment naivety as determinants of faster achievement of ≥10% weight loss. Diabetes status was not associated with faster achievement of ≥10% weight loss.

CONCLUSION

In this real-world Indian cohort, GLP-1/GIP receptor agonists were effective means for weight loss in obese adults, with or without T2D. The magnitude and speed of weight loss outcomes may help in personalising therapy and setting expectations when initiating newer GLP-1/GIP receptor agonists.