Issue 11/2022
T. Khandzhieva-Durlenska
Department of Pharmacology and Toxicology, Faculty of Medicine, Medical University – Sofia
Obesity is a chronic relapsing disease. The main goal in the obesity treatment is not the quantity of weight loss as an endpoint itself, but rather the prevention and treatment of complications to ameliorate health and decrease morbidity and mortality. This perspective is consistent with the ne obesity guidelines and the new diagnostic term adiposity-based chronic disease (ABCD). Many complications require 10-20% weight loss to achieve therapeutic goals. In Jube 2021, semaglutide 2.4 mg/ week was approved for chronic weight management. Phase 3 clinical trials demonstrate that this medication produced >10% placebo-subtracted weight loss, more than half of patients lost ≥15%, and over one third lost ≥20 % of baseline weight. These data double effectiveness over existing obesity medications, provides sufficient weight loss to ameliorate a broad range of complications, and qualifies as the first member of a second-generation class of obesity medications. The second-generation anti-obesity drugs fully enable to treat-to-target approach for management of ABCD. Moreover, the second-generation anti-obesity drug permits active management of body weight as a biomarker to targets associated with effective treatment and prevention of specific complications. ABCD can be now treated similar to other chronic diseases such as diabetes mellitus type 2, arterial hypertension, and atherosclerosis which are treated to specific biomarker targets (e.g. HbA1c, blood pressure, and LDL-cholesterol) to prevent the respective complications of these diseases.
Address for correspondence:
Assoc. prof. Teodora Handjieva-Darlenska
Department of pharmacology and toxicology,
Medical faculty, Medical university, Sofia
2, Zdrave, Str.
1433, Sofia
e-mail: teodorah@abv.bg