Schizophrenia

Cardiometabolic Disturbances in Schizophrenia Patients Improved with Liraglutide

In a recent clinical trial, the glucagon-like peptide-1 receptor agonist liraglutide significantly improved body weight, glucose tolerance, and several other cardiometabolic factors in clozapine- or olanzapine-treated schizophrenia patients with prediabetes and overweight/obesity.

Schizophrenia patients taking antipsychotics have an increased risk of cardiovascular disease due to antipsychotic-induced weight gain. Past intervention efforts to alleviate these effects have had limited success.
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Between May 1, 2013, and February 25, 2016, a total of 103 patients with schizophrenia were randomly assigned to receive a once-daily subcutaneous injection of liraglutide or placebo for 16 weeks, in addition clozapine or olanzapine. All participants studied were overweight or obese and had prediabetes.

Mean participant age was 42.5 years, 58.3% of participants were male, and mean body mass index (BMI) was 33.8.

The researchers defined the primary outcome as change in glucose tolerance estimated by a 75-g oral glucose tolerance test result, and secondary outcomes as change in body weight and cardiometabolic parameters.

A total of 96 (93.2%) participants completed the trial. Results of the trial indicated positive outcomes among the liraglutide group. Overall, a total of 30 (63.8%) participants receiving liraglutide developed normal glucose tolerance, compared with 8 (16.0%) participants receiving placebo.

Additionally, patients taking liraglutide experienced reductions in body weight, waist circumference, systolic blood pressure, visceral fat, and low-density lipoprotein, compared with participants taking placebo.

Adverse events with liraglutide primarily affected the gastrointestinal tract, the researchers noted.

“Liraglutide significantly improved glucose tolerance, body weight, and cardiometabolic disturbances in patients with schizophrenia spectrum disorders treated with clozapine or olanzapine,” the researchers concluded.

—Christina Vogt

Reference:

Larsen JR, Vedtofte L, Jakobsen MSL, et al. Effect of liraglutide treatment on prediabetes and overweight or obesity in clozapine- or olanzapine-treated patients with schizophrenia spectrum disorder: a randomized clinical trial. JAMA Psychiatry. 2017;74(7):719-728.

doi:10.1001/jamapsychiatry.2017.1220.