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The US obesity treatment Semalgultide can reduce up to 13.2 percent of the weight in East Asians, Seoul National University Bundang Hospital said Tuesday based on its phase 3 clinical trial results.

A Seoul National University Bundang Hospital research team, led by Professor Lim Soo, has confirmed Semaglutide’s weight loss effect in East Asians.

The announcement came as the number of obese patients worldwide increased further due to the recent Covid-19 epidemic. East Asians, including Koreans, have a relatively high percentage of abdominal visceral fat, making them more likely to suffer from metabolic problems than Westerners with the same degree of obesity.

Research has shown that Asians with abdominal obesity significantly increase the risk of diabetes and cardiovascular disease even if their body mass index (BMI) is less than 25 kg/m2, which is a range that does not correspond to obesity.

However, a new treatment option may soon be available to Asian obese patients.

A research team led by Professor Lim Soo of the Department of Endocrinology and Metabolism at Seoul National University Bundang Hospital (SNUBH) has confirmed the weight loss effect of Semaglutide, Novo Nordisk’s obesity treatment, in East Asian adults, including Koreans.

To verify the safety and effectiveness of Semaglutide, Professor Lim’s research team conducted a phase 3 trial in 28 hospitals targeting 437 Korean and Japanese obese patients.

In the study, considering the physical characteristics of Asians, the team defined obesity as BMI of 27.0kg/m2 or more and two or more comorbidities of obesity, or BMI of 35.0kg/m2 or more and one or more comorbidities of obesity.

The team identified the actual effect compared to the appropriate dose and placebo through clinical trials divided into 2.4 mg (once) weekly, 1.7 mg (once), placebo, and lifestyle modifications.

As a result, when the team evaluated weight change rate, percentage of participants who lost more than 5 percent of weight, changes in the CT measured visceral fat mass at 68 weeks for each group, the average weight change rate in the group treated with 2.4 mg Semaglutide per week was -13.2 percent, with 82.9 showing a decrease in weight and 40 percent of the patients seeing a decrease in abdominal visceral fat.

This was significantly higher than the placebo group (-2.1, 21, and 6.9 percent) and the 1.7mg weekly group. The adverse reaction rate was also only 2.5 percent, indicating high safety.

“Semaglutide is the first drug that has shown double-digit weight loss in clinical trials,” Professor Lim said. “As it was previously used as a treatment for diabetes, it is also effective in lowering blood sugar and protecting beta cells of the pancreas.”

The team also expects that it will be an excellent therapeutic agent that can comprehensively treat obesity, diabetes, and cardiovascular diseases as it has various advantages such as reducing blood pressure, improving vascular endothelial cell function, and improving cardiac contractility, Lim added.

Lancet Diabetes & Endocrinology published the result of the study in its March issue.

Semaglutide, a representative GLP-1 (glucagon-like peptide-1) analog, received approval as a diabetes treatment in the US in 2017 and is already being actively used in clinical fields abroad. The drug also received approval as an obesity treatment from the US Food and Drug Administration (FDA) in 2021.

The weight loss effect of Semaglutide comes from the gastrointestinal hormone incretin, which is a hormone that promotes insulin secretion by beta cells of the pancreas.

It delays the rate of food excretion from the stomach and acts on the appetite center in the brain hypothalamus to suppress appetite and increase satiety. This reduces overall food intake and induces weight loss.

It also has the effect of helping to lower blood sugar by increasing insulin secretion and decreasing glucagon secretion in a blood sugar-dependent manner during food intake.

When a body secretes insulin more than necessary, blood sugar levels become too low and cause hypoglycemic shock. Semaglutide based on incretin has the advantage of low risk because the secretion amount is controlled (glucose-dependent) according to blood sugar.

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