Health Canada Approves New Obesity Treatment

Hot on the heels of the FDA's recent approval, Health Canada has now also approved the use of a diabetes medication called liraglutide as a weight loss medication for people with or without diabetes.

  

Liraglutide is a medication that has been in use in Canada to treat type 2 diabetes for several years (called Victoza).  As an obesity treatment, it will have a different name, Saxenda; the medication is the same, but the dose to treat obesity is a little higher (based on clinical trials, which you can read more about here).  

Liraglutide can now be used as an adjunct to a reduced calorie diet and increased physical activity for chronic weight management in adult patients with an initial body mass index (BMI) of:

-      30 kg/m2 or greater (obesity), or;

-      27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbidity (e.g., hypertension, type 2 diabetes, or high cholesterol);

and who have failed a previous weight management intervention.

Liraglutide is a derivative of a human hormone called GLP-1, which is released in response to meals.  It works to tell the pancreas to release insulin, and suppresses another hormone involved in blood sugar regulation, called glucagon.  It helps with weight loss by sending a message to the satiety (fullness) centre of your brain, and it has an effect, particularly in the early weeks of treatment, to slow down the stomach.

As for any medication, there are potential risks with using liraglutide.  Common side effects include stomach upset, particularly nausea as the stomach is slowed initially, but this usually improves in the first weeks on the medication.  As for more severe side effects, the question has been raised as to whether this class of medications could cause inflammation of the pancreas (called pancreatitis), but to date, a causative connection has not been established (see more from the FDA and European Medicines Agency on this here).  Liraglutide has been shown to cause a rare form of thyroid cancer in rodents; this has not been seen in humans but is being monitored.  (For further discussion of side effects, see the FDA press release on Saxenda). 

My take on this? The approval of liraglutide for obesity is a landmark, in that this is the first time that a human gut hormone has been approved for obesity treatment.  There are many gut hormones involved in the feeling of fullness, many of which are being actively studied; combinations of these hormones look promising as well.   This is also a landmark decision for Health Canada, in that it has been almost twenty years since a medication was approved for the treatment of obesity in Canada.    

Please refer to my blog post on the FDA's approval last month for my further thoughts on this topic.  

Disclaimer: I was involved in the research trials of liraglutide as an obesity treatment.  I receive honoraria as a continuing medical education speaker and consultant from the makers of liraglutide (Novo Nordisk). I am involved in research of medications similar to liraglutide for the treatment of type 2 diabetes. 

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