Weight loss trajectories with a targeted prescribing pathway for liraglutide 3 mg using multiple stopping rules: findings from the STRIVE study

Malak Hamza; Dimitris Papamargaritis; Werd Al-Najim; Lim Jonathan ZM; James Crane; Bodicoat Danielle H; Shaun Barber; Michael Lean; Barbara McGowan; Donal O; Webb David R; Wilding John PH; le Roux Carel W; Davies Melanie J

doi:10.1530/endoabs.109.P133

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Endocrine Abstracts (2025) 109 P133 | DOI: 10.1530/endoabs.109.P133

SFEBES2025 Poster Presentations Metabolism, Obesity and Diabetes (68 abstracts)

Weight loss trajectories with a targeted prescribing pathway for liraglutide 3 mg using multiple stopping rules: findings from the STRIVE study

Malak Hamza ^1,2 , Dimitris Papamargaritis ^1,2,3 , Werd Al-Najim ⁴ , Jonathan ZM Lim ^5,6 , James Crane ⁷ , Danielle H Bodicoat ⁸ , Shaun Barber ⁹ , Michael Lean ¹⁰ , Barbara McGowan ⁷ , Donal O’Shea ¹¹ , David R Webb ^1,2 , John PH Wilding ⁵ , Carel W le Roux ⁴ & Melanie J Davies ^1,2

Author affiliations

¹Diabetes Research Centre, Leicester General Hospital, University of Leicester College of Life Sciences, Leicester, United Kingdom; ²National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, United Kingdom; ³Department of Diabetes and Endocrinology, Kettering General Hospital, University Hospitals of Northamptonshire NHS Group, Kettering, United Kingdom; ⁴Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland; ⁵Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom; ⁶Diabetes, Endocrinology, and Metabolism Centre, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom; ⁷Diabetes, Endocrinology and Obesity (DEO) Clinical Academic Partnership, King’s Health Partners, Guy’s & St Thomas’ Hospital, London, United Kingdom; ⁸Independent Statistician, Leicester, United Kingdom; ⁹Leicester Clinical Trials Unit, Leicester, United Kingdom; ¹⁰School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom; ¹¹Department of Endocrinology and Diabetes Mellitus, St Vincent’s University Hospital, Dublin, Ireland

Background: The STRIVE study was a 2-year, multicenter, open-label, randomized controlled trial assessing the clinical effectiveness of a targeted prescribing pathway for liraglutide 3 mg with multiple stopping rules (intervention) compared to standard care (control), in specialist weight management services.

Aim: This ad hoc sub-analysis examined the weight loss (WL) trajectories with the application of different stopping rules for liraglutide 3 mg in the intervention arm.

Methods: The trial enrolled 392 participants with a BMI ≥35 kg/m² and at least one obesity-related complication. Of these, 260 participants randomized to the intervention arm and received liraglutide 3 mg, with stopping rules applied at 16 weeks (≥5% WL), 32 weeks (≥10% WL), and 52 weeks (≥15% WL). Participants meeting all three stopping rules continued liraglutide 3 mg for an additional 52 weeks.

Results: • Those not passing the ≥5% WL stopping rule at 16 weeks (mean WL 3.1%), achieved 1% WL at 104 weeks. • Participants not meeting the ≥10% WL stopping rule at 32 weeks (16 weeks mean WL 7.1%, 32 weeks 6.7%), achieved 1.4% WL at 104 weeks. • Those not meeting the ≥15% WL stopping rule at 52 weeks (16 weeks mean WL 9%, 32 weeks 11.3%, 52 weeks 10.1%) managed 5.6% WL at 104 weeks. • Participants meeting all three stopping rules at 52 weeks (16 weeks mean WL 11.5%, 32 weeks 14.7%, 52 weeks 17.1%) achieved 11.4% WL at 104 weeks.

Conclusion: Participants who passed all three stopping rules showed a trend toward greater WL compared to the other groups from the first 16 weeks. Weight regain occurred in those who stopped liraglutide 3 mg due to stopping rules. While those who continued liraglutide 3 mg after passing all rules achieved ≥10% mean WL at 104 weeks, they too experienced weight regain.