Initially used in the treatment of type 2 diabetes, liraglutide can also be indicated for people with obesity whose BMI is above 30. Victoza, Saxenda, Ozempic… What are the differences?
Definition: what is liraglutide?
“Liraglutide is a analogue of GLP-1, a naturally produced hormone by the intestine when we eat and which slows gastric emptying, improves the production of insulin, acts on the production of sugar by the liver and on the appetite centers located directly in the brain. This is a drug that has been used for about ten years in the treatment of type 2 diabetes“, explains Dr. Emmanuelle Lecornet-Sokol, endocrinologist.
Indications: who can take liraglutide?
Liraglutide is indicated for patients with Type 2 diabetes which is not well balanced by treatment with metformin, normally used as a first resort. For 2 years, it has also been indicated for people with obesity (BMI greater than 30).
Obesity and liraglutide
“During studies, scientists have observed a efficacy of high-dose liraglutide on weight loss due to with two actions: the slowing of gastric emptying and the effect on appetite. For 2 years, doctors have therefore been able to prescribe liraglutide for patients who are obese with a BMI greater than 30 or overweight with a BMI between 27 and 30 accompanied by health problems such ashypercholesterolemia, high blood pressure or sleep apnea syndrome“underlines the endocrinologist.
When blood sugar is high, liraglutide stimulates insulin secretion (hormone produced by the liver to regulate blood sugar) and dat the same time reduces excess glucagon (hormone produced by the liver that increases blood sugar levels). This is why it is effective in the treatment of type 2 diabetes. This process also helps to control weight by slowing the passage of food from the stomach to the intestines, allowing the patient to feel a faster and longer satiety effect, thus reducing his appetite.
What are the differences between Victoza, Ozempic and Saxenda?
Several liraglutide drugs have been marketed:
► Victoza: this is a pre-filled pen with 3 possible doses: 0.6 mg/day, 1.2 mg/day or 1.8 mg per day maximum. Victoza should be prescribed to patients with Type 2 diabetes, subject to certain conditions. The injection is daily.
► Saxenda : in the same way as Victoza, it is a pre-filled pen with on the other hand 5 possible doses: 0.6 mg/day 1.2 mg/day, 1.8 mg/day, 2.4 mg/day and 3 mg/day. Saxenda is prescribed for obese patients. The injection is daily. “There is no no difference in composition between Victoza and Saxenda, assures Dr. Lecornet Sokol. Only the indication and thus the dose change. HAS and the laboratory preferred to market the pens under two different names to avoid abuses because one is covered by social security and the other is not.”
► Ozempic : as for Ozempic, it is another analogue of GLP-1 called semaglutide prescribed in the treatment of type 2 diabetes. Unlike Victoza and Saxenda, Ozempic injection is weekly. Moreover, “semaglutide is more potent than liraglutide“. Today, Ozempic is not indicated for obesity. However, many doctors prescribe it to treat overweight, thus causing shortages. “Wegovy, is the name used for the use of semaglutide in high doses in the treatment of obesity but can only be used for the moment by hospital departments specialized in nutrition.”
Injections are ineffective in 10-15% of people
Victoza and Saxenda should be administered once a day subcutaneously, independently of meals, at more or less fixed times. Ozempic should instead be administered once a week. Screw a new needle (these should be changed daily) onto the pen, turn the dose selector until the dose counter shows your dose, insert the needle into the skin (belly, arm, thigh) then press the dose button until the dose counter returns to 0.
What efficiency?
“Sometimes the injections are ineffective. This is the case in 10 to 15% of people without knowing for the moment what is the cause of this non-functioning. THE effects of liraglutide in weight loss may fade over time, after 5 to 6 months in some patients.”
What are the side effects ?
“The most common side effects are nausea, vomiting, diarrhea or abdominal pain. These effects are not serious unless the patient suffers from a particular fragility. Taking liraglutide may increase the risk of pancreatitis and there is some doubt as to the possibility that this may lead to pancreatic and thyroid tumors“, explains Dr. Emmanuelle Lecornet-Sokol.
Whether its use occurs in the context of type 2 diabetes or obesity, the use of one of these drugs must be integrated into a overall weight loss process with a balanced diet and regular physical activity.
“It is important to be followed by his doctor or by a specialist such as an endocrinologist to limit weight regain. Most of the time, the injections gradually stop”.
What price ? Is it covered by social security?
If Victoza and Ozempic are covered by social security as part of the treatment of diabetes and therefore reimbursed but this this is not the case with Saxenda. Its price varies from one pharmacy to another but the cost of a box of 3 injections is around 200 euros. “There is a real subject of difficulty in accessibility because the price can be a barrier to its use“, laments the endocrinologist.
Thanks to Dr Emmanuelle Lecornet-Sokol, endocrinologist, president of the Fenardediam, co-author with Caroline Balma Chaminadour of the book “And if it was hormonal” (Marabout pocket editions).