{'fraction_non_alphanumeric': 0.024893314366998577, 'fraction_numerical': 0.012802275960170697, 'mean_word_length': 5.064655172413793, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Liraglutide in Weight Management.

To the Editor: The report by Pi-Sunyer et al. on the Satiety and Clinical Adiposity — Liraglutide Evidence in Nondiabetic and Diabetic Individuals (SCALE) study (July 2 issue)1 is an important addition to obesity literature. Since this study might encourage long-term use of liraglutide, a glucagonlike peptide-1 (GLP-1) analogue, in many obese patients, we think that safety issues should be the object of particular scrutiny.2 As recently as 2010, the Food and Drug Administration (FDA) required that liraglutide undergo additional studies in animals and that a cancer registry be established to monitor the incidence of medullary thyroid cancer over the next 15 years in patients receiving liraglutide.3 Although it is encouraging that there were no reported cases of medullary thyroid cancer or increases in levels of serum calcitonin, follow-up was limited to 56 weeks and the study was not powered to detect rarer side effects. Of further concern is the imbalance in the incidence of malignant and premalignant breast tumors (10 events in the liraglutide group vs. 3 in the placebo group). As the investigators suggest, this finding might reflect a diagnosis bias, since it occurred more frequently among women who lost more weight, but such a hypothesis constitutes speculation. Further data and considerable caution may be required to avoid previous experiences.4