Pasteurized Akkermansia Muciniphila MucT In Weight Loss Maintenance

Key Takeaways

• MucT was associated with less weight regain than placebo during the maintenance phase.
• Net weight loss from baseline to the end of maintenance was greater with MucT than with placebo.
• Initial Akkermansia spp. abundance was associated with cardiometabolic response, and no serious treatment-related adverse events were observed.

Adults with overweight or obesity who had already completed an 8-week low-energy diet entered a 24-week maintenance phase in a randomized trial published in Nature Medicine. In that phase, daily pasteurized Akkermansia muciniphila MucT was compared with placebo, with change in body weight as the primary maintenance outcome. Because participants had already achieved diet-induced weight loss, the trial focused on weight regain during follow-up. Investigators found less weight regain with MucT than with placebo by the end of follow-up. The findings also included an exploratory association between initial Akkermansia spp. abundance and cardiometabolic response, along with treatment-related safety over the same period.

The study enrolled 90 adults with overweight or obesity who first underwent a structured 8-week low-energy diet before maintenance treatment began. To qualify for randomization, participants needed to achieve at least 8% weight loss during that run-in period. Eligible participants then entered a 24-week healthy ad libitum maintenance phase and received daily pasteurized A. muciniphila MucT or placebo. The primary outcome was change in body weight during maintenance, keeping the analysis focused on regain after diet-induced loss rather than initial weight reduction. The trial evaluated short-term maintenance after successful diet-induced loss.

During maintenance, mean weight regain was 1.2 ± 0.7 kg with MucT and 3.2 ± 0.4 kg with placebo. The between-group comparison favored MucT, with a reported P value of 0.012 for the primary weight outcome. Investigators also reported greater net weight loss from baseline to the end of maintenance with MucT than with placebo (3.1 ± 0.7 kg, P = 0.009). Both weight outcomes favored MucT over the 24-week phase after the initial low-energy diet.

Exploratory analyses indicated an association between initial Akkermansia spp. abundance and cardiometabolic response to MucT. No serious treatment-related adverse events were observed during the trial. The authors highlighted two limitations: the relatively short intervention period and the lack of comparator groups receiving modified strains of MucT lacking active components. They suggested that pasteurized A. muciniphila MucT may represent a strategy for weight-loss maintenance in this setting, limited to the reported 24-week maintenance phase that followed the initial diet intervention.