Navigating the Prescription Landscape of GLP-1 Analogs in France

The introduction of GLP-1 analogs (AGLP-1) in France for obesity management comes with specific guidelines established by the High Authority for Health (HAS). These medications are reserved for patients with an initial body mass index (BMI) greater than or equal to 35 kg/m². Furthermore, the initial prescription must be issued by a specialist in endocrinology-diabetology-nutrition or a physician with equivalent expertise in nutrition, holding a diploma of complementary specialized studies (DESC), a specialized transversal training (FST), or a validation of acquired experience (VAE) in nutrition. This stringent approach ensures that patients receive appropriate care and monitoring.

Professor Sébastien Czernichow, head of the nutrition service at the European hospital Georges-Pompidou (AP-HP, Obesity Center Obésité Île-de-France Ouest) and co-coordinator of the Force network, acknowledges the challenges in determining which patients will respond best to AGLP-1s. He stated that identifying suitable patients remains a question difficile. He also noted that The regulatory context will evolve and we are very awaiting changes in HAS recommendations and decisions of the National Medicines Safety Agency (ANSM). This highlights the dynamic nature of the guidelines and the ongoing efforts to refine them based on emerging evidence.

The Force Network: Unlocking the Secrets of Treatment Response

The Force network, a French obesity Research center of Excellence, is actively working to identify factors influencing treatment response to AGLP-1s. Coordinated by Professor Emmanuel Disse, head of the endocrinology-nutrition service to the Civil Hospices in Lyon (HCL) and co-coordinator of the Force network, the network has established a cohort of over 1,000 patients. This research aims to provide specialists with the insights needed to refine prescriptions and personalize treatment strategies. The network’s efforts are crucial in moving towards a more precise and effective approach to obesity management.

Early findings from the Force network have already highlighted some key individual factors. We observe that women have a better weight response than men, Professor Czernichow reported. Non-diabetics are also better answers than patients with diabetes. The dosage also plays a crucial role, with Professor Czernichow noting, The higher it is indeed, the better the answer. Moreover, research is exploring the potential influence of pharmacodynamics, with Professor Czernichow adding, Polymorphisms of the GLP-1 receptor can influence the response to treatments. the data is still embryonic on this subject. These findings underscore the complexity of obesity and the need for personalized treatment plans.

Towards Precision Medicine: Personalizing Obesity Treatment

The ultimate goal is to achieve Precision medicine, with greater personalization of treatments, based on the characteristics of patients, according to Professor Czernichow.This personalized approach considers various factors, including genetic predispositions, medication use, the impact of obesity on quality of life, and existing comorbidities. The latest HAS recommendations,published in February 2024,emphasize a graded approach to care,starting with an assessment of BMI and the medical and functional repercussions of obesity. This holistic viewpoint aims to provide more effective and tailored interventions for individuals struggling with obesity.

Professor Czernichow anticipates a future where surgical or drug indications will take into account a set of parameters, and no longer only the BMI. This shift reflects a growing understanding of obesity as a complex, multifactorial condition that requires individualized treatment strategies.

A Three-Tiered System for Complete Care

France’s approach to obesity care is structured around a three-tiered system designed to provide access to appropriate care based on individual needs. The general practitioner on the front line, then the city specialist and the 37 centers specializing in obesity (CSO) of the territory for the most complex patients, Professor Sébastien Czernichow explained. This framework is expected to play a central role in a national public health plan focused on obesity, anticipated in March. this thorough system ensures that patients receive the right level of care at the right time.

Irrespective of whether the management strategy involves medication or surgery, Professor Czernichow insists that Dietetics, psychological support and suitable physical activity constitute a common base. He also emphasizes the importance of To approach the subject of weight with kindness with the patient rather than elude the question. this highlights the importance of a holistic approach that addresses both the physical and psychological aspects of obesity.

Addressing Stigma and improving Patient Engagement

Patients often face unpleasant comments and stigma, but Professor Czern

France’s Revolutionary Approach to Obesity: Personalized GLP-1 Analogs & the Path to Precision Medicine

Is France’s pioneering approach to obesity management using GLP-1 analogs a sign of a larger shift towards truly personalized healthcare? Let’s delve into the details with Dr. Annelise Dubois, a leading endocrinologist specializing in obesity management.

World-Today-News: Dr. Dubois, France’s adoption of personalized obesity management with GLP-1 analogs is generating notable interest globally. Can you explain the core principles guiding this new strategy?

Dr. Dubois: Absolutely. The cornerstone of this innovative approach is the recognition that obesity isn’t a one-size-fits-all condition. It’s a complex interplay of genetic predisposition,lifestyle factors,comorbidities,and individual responses to treatment. This personalized strategy uses GLP-1 receptor agonists (like GLP-1 analogs,also known as AGLP-1s),but restricts their initial prescription to individuals with a BMI of 35 kg/m² or higher under the strict oversight of specialists. This ensures appropriate patient selection and monitoring, maximizing efficacy and minimizing potential side effects. We’re moving away from a blanket approach and towards tailored interventions.

World-Today-News: The High Authority for Health (HAS) plays a crucial role in this process. Can you elaborate on their involvement and the specific guidelines they’ve established?

Dr. Dubois: The HAS sets the regulatory framework, defining strict eligibility criteria. Initial prescriptions of GLP-1 analogs for obesity management are restricted to specialists in endocrinology, diabetology, and nutrition. This ensures patients receive the appropriate medical guidance and continuous support. The HAS’s involvement ensures a cautious, evidence-based rollout of this promising treatment, preventing widespread misuse and protecting patient safety. These guidelines are periodically reviewed and updated based on accumulating research data.

World-Today-News: The Force network is mentioned frequently. What is its role in advancing personalized obesity management in France?

Dr. Dubois: The Force network is a collaborative research initiative crucial to understanding the nuances of individual responses to AGLP-1s. They’re actively building a large patient cohort to unravel the complex factors determining treatment success. This research is essential for refining prescription guidelines and adapting treatment strategies—in essence, it helps to individualize treatment based on the specific needs and physiology of individual patients. Their work is providing invaluable insights into which patients might respond best to medication, age, gender, or the existence of conditions like diabetes. This will enable us to offer more effective and precise therapeutic options.

World-Today-news: What are some key findings emerging from the Force network’s research? What factors are influencing treatment response?

Dr. Dubois: The Force network’s research has yielded several captivating observations.They’ve found that women frequently enough exhibit a better weight response than men, and non-diabetic patients tend to respond more effectively than those with diabetes. Furthermore, dosage plays a significant role – higher dosages generally correlate with better outcomes. Perhaps most compelling is the emerging research into how genetic polymorphisms related to the GLP-1 receptor could influence treatment responses. This highlights the complexities involved and the importance of genetic screening for personalized treatment. The findings further support the need for a thoroughly personalized approach to obesity management.

World-Today-News: How does this approach to obesity management fit into the broader vision of precision medicine?

Dr. Dubois: The ultimate aim is to achieve precision medicine for obesity. It’s about moving beyond a simple BMI assessment and integrating factors like genetics, comorbidities, lifestyle, and even the patient’s own perception of the impact of obesity on their quality of life into treatment decisions. The initial steps,like stricter guidelines and research from the Force network,are a movement towards this precision-based approach. Imagine a future where obesity treatments are carefully tailored to each individual’s unique biochemical profile, offering more effective and targeted interventions. This moves us beyond simply treating a BMI score and directly addresses underlying health and well-being.

World-Today-News: Can you describe the three-tiered system France has implemented for obesity care?

Dr. Dubois: The system comprises three levels of care. It starts with the general practitioner who is the patient’s first point of contact and responsible for the initial assessment. Then, city specialists provide further assessment and consultation, and specialized obesity centers cater to individuals with the most complex cases. This tiered approach ensures patients receive appropriate care relative to their needs, avoiding overburdening specialized resources. This tiered approach is cost-effective, efficient, and patient focused.

World-Today-News: how is France addressing the social stigma frequently enough associated with obesity?

Dr. Dubois: Addressing the stigma is crucial. The focus should always be compassionate and patient-centric.This new approach empowers individuals within a supportive healthcare system. It’s about fostering open conversations, offering thorough psychological counseling alongside other interventions, and rejecting judgmental attitudes. we aim to create a supportive treatment journey where patients feel agreeable discussing and overcoming obesity challenges.

World-Today-News: Dr. Dubois, thank you for shedding light on this revolutionary approach. your insights are invaluable. Readers, please share your thoughts and perspectives in the comments below.Let’s continue the conversation about tailored approaches to health issues.