GLP-1 Therapies Newsletter
Issue #26March 2, 20267 studies

86.5% of patients on semaglutide or tirzepatide lost at least 5% of body weight at 6 months in Medicaid study

The GLP-1 revolution continues to generate new insights as real-world data pours in from diverse patient populations. This week's research reveals how these medications perform outside clinical trials—and uncovers some surprising connections beyond weight loss.

📊 Medicaid patients show strong weight loss on GLP-1s despite moderate adherence

  • Among 7,493 Massachusetts Medicaid members, 60.8% stayed on their GLP-1 medication and 60.1% took it consistently over 6 months

  • Of those who remained on treatment, 86.5% achieved at least 5% weight loss from baseline

  • Younger patients under 40, men, and those with diabetes were more likely to discontinue treatment early

Why it matters: This real-world evidence shows GLP-1 medications work effectively in lower-income populations, though adherence challenges remain significant—nearly 40% of patients stopped taking their medication within 6 months.

Key Findings

🎯 Combination drug CagriSema beats semaglutide alone for weight loss

  • CagriSema (semaglutide plus cagrilintide) produced significantly greater weight loss than semaglutide alone across 4 trials with 4,419 participants

  • The combination achieved an additional 11 kg of weight loss compared to controls

  • Gastrointestinal side effects were 32% more common with the combination therapy

💡 Dual-target obesity drugs may offer superior weight loss but come with increased side effects.
Top 20% journal 🔗 The American journal of cardiology 🗓️ Feb 27

🔬 Flexible dosing reduces dropouts while maintaining weight loss

  • In 111 Italian patients, only 26% reached the maximum 2.4 mg semaglutide dose, while 40% stayed at 1 mg

  • Patients achieved 5-20% weight loss regardless of their final dose

  • Early discontinuation dropped to just 10.5% at 6 months with flexible dosing approaches

💡 Personalized dosing strategies may help more patients stay on GLP-1 medications long-term.
🥉 Top 5% journal 🔗 Diabetes, obesity & metabolism 🗓️ Feb 23

💊 Reduced-frequency dosing maintains benefits after initial weight loss

  • 30 patients who achieved weight plateau on weekly GLP-1s switched to every-other-week dosing

  • Weight continued to decline from 74.1 kg to 72.4 kg over 36 weeks of reduced-frequency treatment

  • Metabolic improvements were maintained throughout the extended period

💡 Less frequent dosing may be a viable maintenance strategy after initial weight loss goals are met.
🎖️ Top 10% journal 🔗 Obesity (Silver Spring, Md.) 🗓️ Feb 24

🧬 Primary cilia in pancreas cells are essential for GLP-1 signaling

  • Mouse and human pancreatic cells without primary cilia showed severely impaired insulin secretion in response to GLP-1

  • GLP-1 receptors were found localized specifically to these cellular antenna-like structures

  • Disrupting cilia function blocked the drugs' effects even when cilia structure remained intact

💡 This discovery reveals a previously unknown cellular mechanism that could inform future diabetes drug development.

🛡️ GLP-1s linked to reduced infection risk in kidney disease patients

  • Semaglutide reduced serious infections by 21% and COVID-19 hospitalizations by 24% in the FLOW trial of 1.85 million participants

  • Benefits were greatest in patients with poor blood sugar control (37% reduction) and severe kidney disease (47% reduction)

  • Overall infection-related deaths and hospitalizations dropped significantly

💡 GLP-1 medications may offer unexpected immune benefits beyond their metabolic effects.
🎖️ Top 10% journal 🔗 Nephrol Dial Transplant 🗓️ Feb 23

🔍 No increased cancer risk found across 93 clinical trials

  • Meta-analysis of 1.85 million participants showed no increased gastrointestinal cancer risk with GLP-1 medications

  • Colorectal cancer risk appeared 19% lower and liver cancer risk 26% lower in treated patients

  • Pancreatic cancer concerns were not supported by the pooled trial data

💡 Large-scale evidence provides reassurance about cancer safety concerns that have surrounded these medications.
Top 20% journal 🔗 Frontiers in pharmacology 🗓️ Feb 26

Implications

This week's research paints a picture of GLP-1 medications that are both more versatile and more forgiving than initially expected. The drugs work across diverse populations, can be dosed flexibly, and may offer benefits extending far beyond weight loss—from infection protection to cancer risk reduction.

Studies in this issue

Primary sources used for this newsletter.

  1. Six-month use, sticking to treatment, and effectiveness of GLP-1 medicines for overweight and obesity in Medicaid patients
    main storyJournal of managed care & specialty pharmacy2026-02-27PMID 41760563
  2. Less Frequent GLP1 Treatment Maintains Weight, Body Makeup, and Metabolic Health Improvements: A Case Series
    key findingObesity (Silver Spring, Md.)2026-02-24PMID 41732031
  3. Comparing CagriSema, Semaglutide, and Placebo for Treating Obesity: A Review and Analysis of Clinical Trials
    key findingThe American journal of cardiology2026-02-27PMID 41759565
  4. Primary cilia control GLP-1 signaling in insulin-producing pancreatic cells
    key findingbioRxiv : the preprint server for biology2026-02-27PMID 41757129
  5. Semaglutide’s impact on COVID-19 and other infections in the FLOW clinical trial
    key findingNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2026-02-23PMID 41728915
  6. Review of cancer risk in the digestive system linked to GLP-1 receptor agonist drugs
    key findingFrontiers in pharmacology2026-02-26PMID 41743116
  7. Flexible semaglutide dosing lowers early treatment stopping while keeping similar results in obese patients
    key findingDiabetes, obesity & metabolism2026-02-23PMID 41725422

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