Saxenda (liraglutide) is one of two drugs licensed in the UK for weight loss. The effectiveness of Orlistat in weight loss is covered in a separate post, Orlistat review: Can you achieve a weight loss? Saxenda is the brand name of the drug liraglutide, which is also know as Victoza. Victoza has been used in treatment of type 2 diabetes in the UK since 2009.
Saxenda (liraglutide) weight loss: what is the license in UK?
Saxenda (liraglutide) was introduced to the UK in 2017. It is licensed as part of reduce calorie diet and increased physical activity in obese patients with BMI more than 30 or less than 30 but more than 27 (overweight) who have weight related conditions such as prediabetes, diabetes, hypertension, dyslipidemia.
In addition, if satisfactory loss of body weight is not achieved (reduction by 5% of initial body weight) in 12 weeks, treatment will be discontinued.
Liraglutide (Victoza) is licensed in treatment of type 2 diabetes.
Saxenda mechanism of action?
Without going deep into science Saxenda’s mechanism of action is described as hormonal. Saxenda mimics actions of GLP-1 hormone (found in our body) to decrease appetite and increased satiety (Sexandapro.com, ND), which contributes to weight loss.
Saxenda weight loss effectiveness?
The main evidence behind effectiveness of Saxenda comes from 4 clinical trials. Patients who used Saxenda were obese or overweight and had co-morbidity such as hypertension. During the trials there was a significant difference in weight loss between patients who used Saxenda and patients who used placebo product. All patients who participated in clinical trials received lifestyle interventions for weight loss. Across all studies (duration between 32-160 weeks) the estimated weight loss was between 5.4% and 4% (NICE, 2017). However, many patients regained the weight after stopping the treatment.
Some studies have show significantly higher difference in weight loss in patients who lost more than 5% and more than 10% of body weight during trial as compared to patients who used placebo.
For more details about all trials visit NICE website.
Saxenda (liraglutide) warnings
One of the first warnings that pop up when visiting www.saxendapro.com is important safety information about risks of thyroid C-cell tumors (Saxendapo.com, ND):
- Liraglutide cause dose-dependent and treatment duration dependent thyroid C-cell tumors in both rats and mice
- It is not know if Saxenda has the same effect in humans
- Acute Pancreatitis including fatal and non-fatal hemorrhagic or necrotizing pancreatitis (postmarketing data)
- Acute gallbladder disease
- Risk of hypoglycaemia when used with other ant-diabetic drugs
- Heart rate increase
- Renal impairment
- Hypersensitivity reactions
- Suicidal behaviors:
- In clinical trial 9 of 3384 patients (0.3%) treated with Saxenda repored suicidal thoughts (0.1% for placebo) with 1 attempted suicide.
For more information visit SaxendaPro website.
Saxenda (liraglutide) cost
A month supply of Saxenda costs £196.20 (MIMS, 2017)
Saxenda on NHS?
Saxenda can be prescribed in the UK. Saxenda is not commonly prescribed in UK. Prescribing information available on OpenPrescibing.net shows that it was only prescribed 13 times in January 2019 (increase from 7 in December 2018).
As of today Saxenda use in NHS is very limited and not included in NICE recommendations on identifying, assessing and managing obesity. The only current treatment option recommended by this guide is Orlistat.
European Medicine Agency which publishes reports for each medication that receives marketing authorisation noted that it is ‘unlikely that any potential weight loss achieved with liraglutide’ will continue after the treatment is stopped.
NICE (2017). Obese, overweight with risk factors: liraglutide (Saxenda). Available at: https://www.nice.org.uk/advice/es14/chapter/Key-points Accessed on 16/03/2019
MIMS (2017). Saxenda. Available at: https://www.mims.co.uk/drugs/nutrition/obesity/saxenda Accessed on 16/03/2019
Sexandapro.com (ND). Mechanism of action. Available at: https://www.saxendapro.com/how-saxenda-works.html Accessed on 16/03/2019