GLP-1 Therapy After Bariatric Surgery in Chinese Patients With Obesity

ConditionObesity
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-60
SponsorChina-Japan Friendship Hospital

About this trial

Obese patients exhibit considerable heterogeneity and complex comorbidities, making long-term effective management challenging with monotherapy. While bariatric surgery remains the most effective weight-loss intervention, postoperative weight regain and metabolic deterioration remain significant concerns. glucagon-like peptide-1 receptor agonists (GLP-1RA) offer distinct advantages for weight loss and metabolic control, and their combination with surgery may produce synergistic effects. This study investigates the efficacy and safety of bariatric surgery combined with adjuvant GLP-1 receptor agonist therapy for Chinese patients with obesity.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Patients undergoing initial laparoscopic sleeve gastrectomy (LSG).

obesity:BMI ≥30 kg/m².

Metabolic comorbidities: Diagnosis of metabolic syndrome or type 2 diabetes mellitus (T2DM) meeting standard criteria.

Age range: 18-60 years (inclusive).

Disqualifiers

Recent GLP-1RA use: Treatment with GLP-1 receptor agonists within 6 months preoperatively.

Prior bariatric surgery: History of any metabolic/bariatric surgical procedure.

Postoperative complications: Requiring reoperation for severe complications (e.g., hemorrhage, anastomotic leak).

Non-indicated candidates: Patients not meeting standard bariatric surgery indications.

Trial design

Design model

Parallel

Treatments tested in this trial

  • LSG-Semaglutide group

    Combination product

    1. Basic Treatment Measures Within 0-30 days after sleeve gastrectomy, all patients received very low-calorie enteral nutrition powder (100 kcal/day). From 30 to 90 days post-surgery, a low-energy diet (400 kcal/day) was provided. Beyond 90 days post-surgery, a calorie-restricted diet was implemented (1,500 kcal/day for men and 1,200 kcal/day for women). 2. In addition to laparoscopic sleeve gastrectomy and postoperative basic nutritional counseling,the LSG-Semaglutide group received subcutaneous semaglutide injections from 1 to 6 months postoperatively.The specific protocol was as follows:In the intervention group, semaglutide treatment was initiated at 1 month after LSG. The starting dose was 0.25 mg per week and was subsequently titrated up based on individual patient response to a maximum maintenance dose of 2.4 mg per week. The treatment continued until the completion of the 6-month postoperative period.

  • LSG-Mazdutide group

    Combination product

    1. Basic Treatment Measures Within 0-30 days after sleeve gastrectomy, all patients received very low-calorie enteral nutrition powder (100 kcal/day). From 30 to 90 days post-surgery, a low-energy diet (400 kcal/day) was provided. Beyond 90 days post-surgery, a calorie-restricted diet was implemented (1,500 kcal/day for men and 1,200 kcal/day for women). 2. In addition to laparoscopic sleeve gastrectomy and postoperative basic nutritional counseling,the LSG-Mazdutide group received subcutaneous Mazdutide injections from 1 to 6 months postoperatively.The specific protocol was as follows:In the intervention group, Mazdutide treatment was initiated at 1 month after LSG. The starting dose was 2 mg per week and was subsequently titrated up based on individual patient response to a maximum maintenance dose of 6 mg per week. The treatment continued until the completion of the 6-month postoperative period.

  • LSG-Tirzepatide group

    Combination product

    1. Basic Treatment Measures Within 0-30 days after sleeve gastrectomy, all patients received very low-calorie enteral nutrition powder (100 kcal/day). From 30 to 90 days post-surgery, a low-energy diet (400 kcal/day) was provided. Beyond 90 days post-surgery, a calorie-restricted diet was implemented (1,500 kcal/day for men and 1,200 kcal/day for women). 2. In addition to laparoscopic sleeve gastrectomy and postoperative basic nutritional counseling,the LSG-Tirzepatide group received subcutaneous Tirzepatide injections from 1 to 6 months postoperatively.The specific protocol was as follows:In the intervention group, Tirzepatide treatment was initiated at 1 month after LSG. The starting dose was 2.5 mg per week and was subsequently titrated up based on individual patient response to a maximum maintenance dose of 10 mg per week. The treatment continued until the completion of the 6-month postoperative period.

  • LSG group

    Procedure/Surgery

    1. Basic Treatment Measures Within 0-30 days after sleeve gastrectomy, all patients received very low-calorie enteral nutrition powder (100 kcal/day). From 30 to 90 days post-surgery, a low-energy diet (400 kcal/day) was provided. Beyond 90 days post-surgery, a calorie-restricted diet was implemented (1,500 kcal/day for men and 1,200 kcal/day for women). 2. Observation Group: Received only basic nutritional recommendation interventions after surgery.

Treatment groups

200 Participants
are divided into 4 treatment groups
Group A: LSG-Semaglutide groupExperimental treatment 1 intervention
Group B: LSG-Mazdutide groupExperimental treatment 1 intervention
Group C: LSG-Tirzepatide groupExperimental treatment 1 intervention
Group D: LSG groupOther 1 intervention

Trial outcomes

Primary outcomes

1

Percentage of weight loss.

Time frame
Immediately postoperatively (Day 0), and at 1, 3, 6, and 12 months postoperatively.

Secondary outcomes

1

Weight in kilograms

Time frame
Immediately postoperatively (Day 0), and at 1, 3, 6, and 12 months postoperatively.
2

Waist circumference in centimeters

Time frame
Immediately postoperatively (Day 0), and at 1, 3, 6, and 12 months postoperatively.
3

Hip circumference in centimeters

Time frame
Immediately postoperatively (Day 0), and at 1, 3, 6, and 12 months postoperatively.
4

Blood pressure

Time frame
Immediately postoperatively (Day 0), and at 1, 3, 6, and 12 months postoperatively.

Other outcomes

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