Effectiveness of a pragmatic prescribing pathway with multiple stopping rules for liraglutide 3 mg in people with and without diabetes: a post-hoc analysis of 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.P155

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Endocrine Abstracts (2025) 109 P155 | DOI: 10.1530/endoabs.109.P155

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

Effectiveness of a pragmatic prescribing pathway with multiple stopping rules for liraglutide 3 mg in people with and without diabetes: a post-hoc analysis of 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: Previous studies suggest that individuals with obesity and type 2 diabetes (T2D) may lose less weight with liraglutide 3 mg compared with those without diabetes. The STRIVE study, a 2-year, randomised controlled trial, evaluated the effectiveness of a targeted prescribing pathway for liraglutide 3 mg with multiple stopping rules versus standard care in specialist weight management services (SWMS).

Aim: This sub-analysis compared the effectiveness of the targeted prescribing pathway for liraglutide 3 mg on weight loss (WL) between individuals with or without T2D.

Methods: The STRIVE study recruited 392 participants with BMI >35 kg/m² who presented to SWMS. Participants were randomised 2:1 to the intervention (targeted prescribing pathway for liraglutide 3 mg, n = 260) or control (standard care, n = 132) arm. In the intervention arm, stopping rules were applied at 16 weeks (≥5% WL), 32 weeks (≥10% WL), and 52 weeks (≥15% WL). Diabetes status at baseline was available for 259 participants.

Results: In the intervention arm, 67.1% (102/152) of participants without T2D and 74.8% (80/107) with T2D passed the ≥5% WL stopping rule (16 weeks, P = 0.343). At 32 weeks, 42.8% without T2D (65/152) and 44.9% with T2D (48/107) passed the ≥10% WL rule (P = 0.916). At 52 weeks, 20.4% without T2D (31/152) and 21.5% with T2D (23/107) passed the ≥15% WL rule (P = 0.977) and continued liraglutide 3 mg for another 52 weeks. At 52 and 104 weeks, the mean difference in % WL with the targeted prescribing pathway versus standard care was similar between people with and without T2D (-4.4% vs -5.9% at 52 weeks; -3.4% and -4.4% at 104 weeks; p for interaction=0.377 and 0.532, respectively).

Conclusion: There were no differences in passing the stopping rules or % WL between people with and without T2D with the targeted prescribing pathway for liraglutide 3 mg, suggesting similar effectiveness of the pathway regarding WL for both groups.