P3161 - Efficacy and Safety of Subcutaneous Semaglutide and Tirzepatide Injections in Elderly vs Younger Obese: A Case-Control Study

Yousif Arif, MD¹, Vahagn Aldzhyan, MS², Christine Lam, PhD², Elizza E. Villarruel, BS³, Ruvimbo Dzvurumi, BS², Diego Cisneros, BS², Dima Bechenati, MD⁴, Demetrios Stavrakis, MD², Na Shen, MD², Danny Issa, MD^2
1David Geffen School of Medicine at UCLA, Mission Viejo, CA; ²David Geffen School of Medicine at UCLA, Los Angeles, CA; ³David Geffen School of Medicine at UCLA, La Puente, CA; ⁴Mayo Clinic, Rochester, MN

Introduction: The risk of bariatric surgery can outweigh the benefit for many elderly obese patients, thus precipitating an alternative treatment plan. The safety and efficacy of glucagon-like peptide-1 receptor agonists (GLP1_RA) among the elderly who may not qualify for bariatric surgery have yet to be studied.

Methods: We performed a retrospective study of obese patients who were treated with subcutaneous semaglutide or tirzepatide injections for weight loss at a multidisciplinary weight-loss clinic since 2020. Our weight loss clinic offers primary and revision endobariatric therapy as well as anti-obesity agents. Patients were divided into younger than 65 years old and equal to or older than 65 at the time of GLP1 initiation. Patients with a history of bariatric surgery or endoscopy were excluded. Primary outcome was total body weight loss (TBWL), both absolute and percentage, at 3, 6, and 12 months after the initiation of treatment. Secondary outcomes were adverse events related to medication use. Categorical variables were compared with Chi-squared test, and continuous nonparametric variables were compared with Wilcoxon rank sum test and reported as median (IQR). A univariate analysis was conducted for all variables.

Results: A total of 114 obese patients were included: 71 (62.3%) patients < 65 years old and 43 (38.7%) ≥ 65 years old. The majority of the patients (73.7%) were female. Those younger than 65 had a higher baseline weight (105 vs. 91.4 kg, respectively) and BMI (38.1 vs. 32.4 kg/m2, respectively), while the elderly group had a higher number of obesity-related comorbidities (Table 1). GLP1_RAs lead to a significantly higher mean %TBWL in the younger patient group at three months (5 vs. 3, P=0.0002), six months (9% vs. 5%; P=0.0003), and 12 months after treatment start (12% vs. 7%; P< 0.0001) compared to elderly, respectively. There were no statistically significant differences between the two age groups for any adverse event categories.

Discussion: This real-world study shows that GLP1_RA injections achieved a comparable safety profile but lower weight loss outcomes in the elderly compared to young obese patients followed for 12 months on treatment. Given the aging population and increasing prevalence of obesity and related comorbidity, future research is strongly warranted to confirm our findings.



Disclosures:


Yousif Arif, MD¹, Vahagn Aldzhyan, MS², Christine Lam, PhD², Elizza E. Villarruel, BS³, Ruvimbo Dzvurumi, BS², Diego Cisneros, BS², Dima Bechenati, MD⁴, Demetrios Stavrakis, MD², Na Shen, MD², Danny Issa, MD². P3161 - Efficacy and Safety of Subcutaneous Semaglutide and Tirzepatide Injections in Elderly vs Younger Obese: A Case-Control Study, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.