Sustained weight loss exceeding 100 kg with sequential incretin-based therapy in Prader-Willi syndrome.

Case report of a single adult patient with Prader-Willi syndrome

“Herein, we report the case of a functional adult with genetically confirmed PWS who achieved an exceptional and sustained weight loss exceeding 100 kg, along with complete remission of type 2 diabetes, after a strategic, sequential incretin-based therapy combined with a structured lifestyle intervention.”

A 29-year-old man with genetically confirmed maternal uniparental disomy Prader-Willi syndrome, severe obesity, and newly diagnosed type 2 diabetes

“We report a 29-year-old man with genetically confirmed maternal uniparental disomy PWS who presented with severe obesity (185 kg; body mass index [BMI] 59.7 kg/m2) and newly diagnosed type 2 diabetes (glycated hemoglobin [HbA1c], 8.3% [SI: 67 mmol/mol] [reference range, <5.7% (SI: <39 mmol/mol)]).”

One patient

“Herein, we report the case of a functional adult with genetically confirmed PWS who achieved an exceptional and sustained weight loss exceeding 100 kg, along with complete remission of type 2 diabetes, after a strategic, sequential incretin-based therapy combined with a structured lifestyle intervention.”

18 months from initiation of therapy

“At the 18-month follow-up from initiation of retatrutide therapy (and approximately 4 months after discontinuation of dulaglutide), body weight had decreased from 185.0 to 76.3 kg, representing a total weight loss of 108.7 kg (58.8% of initial body weight).”

Total body weight decreased by 58.8% (108.7 kg) over 18 months

“At the 18-month follow-up from initiation of retatrutide therapy (and approximately 4 months after discontinuation of dulaglutide), body weight had decreased from 185.0 to 76.3 kg, representing a total weight loss of 108.7 kg (58.8% of initial body weight).”

Glycated hemoglobin (HbA1c) decreased from 8.3% to 4.9%, consistent with diabetes remission

“Glycemic control remained excellent, with glycated hemoglobin (HbA1c) declining from 8.3% (SI: 67 mmol/mol) to 4.9% (SI: 30 mmol/mol) and fasting plasma glucose from 122 mg/dL (SI: 6.8 mmol/L) to 84 mg/dL (SI: 4.7 mmol/L), consistent with sustained diabetes remission during sequential incretin-based therapy.”

Skeletal muscle mass was 38.5 kg after weight loss, with no serious adverse events reported

“Follow-up bioimpedance showed a skeletal muscle mass of 38.5 kg after a 58.8% reduction in total body weight.”

Single case report with short follow-up after therapy discontinuation, lack of baseline body composition measurements, and absence of formal growth hormone deficiency evaluation

“A limitation of this report is the relatively short follow-up after discontinuation of incretin-based therapy.”