A recent study presented on May 20, 2024, at the Digestive Disease Week (DDW) 2024 annual meeting (abstract 638) explored a potential test for predicting patient response to semaglutide for weight loss. The authors used a commercially available test that looks for 40 genetic variants used to identify individuals with the “hungry gut” obesity phenotype to demonstrate the correlation between people with the “hungry gut” phenotype and patients that were most responsive to semaglutide for weight management.
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The study included 84 adult patients receiving weight loss treatment at Mayo Clinic, who were prescribed GLP-1 semaglutide. Using a machine learning genetic risk score to identify patients with the hungry gut phenotype, the researchers classified participants as either “hungry gut” positive (n=51) or “hungry gut” negative (n=33). Patients had their total body weight loss measured at 3, 6, 9 and 12 months, with researchers assessing whether the genetic risk score could effectively predict patients’ response to semaglutide. The researchers defined this parameter as ≥ 5% of total body weight loss measured at 12 months.
While there were no noticeable differences between the hungry gut positive and hungry gut negative groups’ weight loss at 3 and 6 months, by 9 months, the difference in responsiveness began to increase. According to the study, at 9 months, patients in the positive group lost 14.4% of their total body weight compared to 10.3% lost in the negative group (P = .045). After 12 months the positive group had lost a total of 19.5%, while the negative group lost a total of 10.0% (P = .01), confirming the genetic test’s efficacy in predicting patient response to semaglutide for weight loss.
Like the test to predict patient response to oral minoxidil, this genetic test will help cut out much of the guesswork for practitioners, so they can hone in on the right treatment for their patient faster. “We can now tell with confidence who is going to respond to semaglutide,” said Andres Acosta, M.D., Ph.D., Associate Professor of Medicine at Mayo Clinic. "For nonresponders, we can think about other interventions or medications that we have available."
