by The next wave of obesity drugs is coming soon.
Drug companies are racing to develop GLP-1 drugs after the great success of Novo Nordisk’s Ozempic and Wegovy and Eli Lilly’s Mounjaro and Zepbound.
Some of the experimental drugs could go beyond diabetes and weight loss, improving liver and heart function and reducing side effects such as muscle loss common to existing medications. At the American Diabetes Association’s 2024 conference in Orlando, Florida, researchers are expected to present data on 27 GLP-1 drugs in development.
“We’ve heard about Ozempic and Mounjaro and so on, but now we’re seeing a lot of different drug candidates in the pipeline, from very early pre-clinical all the way through the late clinical stage,” said Dr. Marlon Pragnell, ADA vice president of research and science. “It’s very exciting to see that right now.”
Much of the data presented comes from animal studies or early phase human trials. However, some presentations include mid- to late-stage tests, according to a list shared by the organization.
Food and Drug Administration approval is likely years away for most. Some of the drugs shown may be available for prescription in the US in the next few years.
“We’ve seen an unprecedented acceleration in GLP drug development,” said Dr. Christopher McGowan, a gastroenterologist who runs a weight loss clinic in Cary, North Carolina. “We are now firmly entrenched in the GLP era.”
Although the current drugs are very effective, there is a need for new drugs that are more affordable and have fewer side effects, McGowan said.
GLP-1 drugs aren’t the only thing going on. On Thursday, ahead of the diabetes conference, Danish biotech firm Zealand Pharma released data showing a high dose of its experimental weight loss drug petrelintide helped reduce body weight by an average of 8.6% at 16 weeks.
The weekly injection medication is unique because it mimics the hormone amylin, which helps control blood sugar. Patients are expected to experience fewer side effects such as nausea that are commonly associated with GLP-1 drugs such as Wegovy and Zepbound.
Can glucagon hormone help with weight loss?
GLP-1 medications work, in part, by slowing down how quickly food passes through the stomach, making people feel fuller for longer. In some of the upcoming weight loss drugs, a different hormone called glucagon is in the spotlight. Glucagon is a vital blood sugar regulating hormone that can mimic the effects of exercise.
One of the drugs featured at Sunday’s conference is called pemvidutide, from Maryland-based biotech firm Altimmune.
The drug contains the hormone GLP-1, a main ingredient in Ozempic and Wegovy, as well as glucagon.
Altimmune released data from a phase 2 trial of 391 obese or overweight adults with at least one weight-related comorbidity, such as high blood pressure. Patients were randomized to receive one of three doses of pemvidutide or placebo for 48 weeks.
Researchers found that patients who received the highest dose of the drug lost an average of 15.6% of their body weight after 48 weeks, compared to the 2.2% weight loss seen in patients who received a placebo. In similar trials, semaglutide has been shown to reduce body weight by about 15% after 68 weeks.
These are not direct comparisons because the drugs were not compared in a head-to-head clinical trial.
Dr. Scott Harris, Altimmune’s chief medical officer, said the drug has been shown to help people lose weight, as well as provide health benefits for the liver and heart. In addition, the drug has shown benefits in preserving lean body mass. Some studies have suggested that semaglutide, the active ingredient in Ozempic and Wegovy, can cause muscle loss.
“If people take the drugs long-term, what will happen to them long-term? What are the long-term effects on their body composition, on their musculature, on their ability to function?” he said.
Harris said people who received pemvidutide lost an average of 21% of their lean body mass, which is lower than the roughly 25% of lean body mass that people typically lose through diet and exercise.
“We are the next wave of obesity drugs,” said Altimmune President and CEO Vipin Garg. “The first wave of mechanisms was driven by appetite suppression. We are adding another component.”
Altimmune hopes to start a phase 3 trial soon. The company hopes to have the drug available in the US sometime in 2028.
Competition could reduce costs
Increasing the number of weight loss drugs available is important for several reasons, experts say.
More options could also help ease the perceived shortage in the US of Novo Nordisk and Lilly’s weight loss drugs.
Increased competition could reduce the high cost of drugs over time. A month’s supply of Wegovy or Zepbound can cost more than $1,000, often financially prohibitive for many patients, experts say.
Patients can also respond differently to treatments, said Dr. Fatima Cody Stanford, an associate professor of medicine and pediatrics at Harvard Medical School. In fact, some of the existing GLP-1 alternatives are ineffective.
“Different GLP-1 drugs may have different levels of efficacy and potency,” she said. “Some patients may respond better to one drug over another, depending on how their body metabolizes and responds to the medication.”
Since starting Ozempic in June 2022, Danielle Griffin has not seen the results her doctor predicted. “She really expected to see a big difference in my weight, and I never saw it,” said the 38-year-old from Elida, New Mexico. Griffin weighed about 300 pounds and only lost about 10 pounds in two years. She said her expectations were “quite high from there.”
Amid insurance battles and shortages, she also tried Wegovy and Mounjaro, but saw no difference in her weight.
“I don’t think there are options, especially for me, for someone for whom the medications aren’t working.”
The prospect of new medicines on the horizon excites Griffin. “I’d be happy to try it,” she said, adding that it could be life-changing, honestly, and you know that gives me something to look forward to. looking forward to it.”
More drugs on the way
Two other GLP-1 drugs are being developed by Eli Lilly, which makes Zepbound and the diabetes version Mounjaro.
On Sunday, Lilly released new data about retatrutide, an injectable drug that combines GLP-1 and glucagon, as well as another hormone called GIP. GIP is thought to improve the way the body breaks down sugar.
In an earlier trial, retatrutide helped people lose, on average, about 24% of their body weight, equivalent to about 58 pounds—more weight loss than any other drug on the market.
New results showed that the weekly medication significantly reduced blood sugar levels in people with Type 2 diabetes.
On Saturday, new results were also found on the experimental mazdutide, which Lilly is developing in partnership with the Chinese biotechnology firm Innovent Biologics. The drug combines GLP-1 and glucagon.
In a phase 3 study of overweight or obese adults in China, researchers found that after 48 weeks, a 6-milligram dose of the drug resulted in a 14.4% reduction in average body weight.
The drug also led to a reduction in serum uric acid – a chemical that can accumulate in the bloodstream, cause health problems, and is associated with obesity, according to Dr. Linong Ji, director of Peking University Diabetes. Center, presented. the results.
That was “pretty unique and never reported for other GLP-1-based therapies,” he said in an interview.
The drug could be approved in China in 2025, Ji said.
Improve metabolic conditions
An estimated 75% of obese people have non-alcoholic fatty liver disease and 34% have MASH, or steatohepatitis associated with metabolic dysfunction, according to researchers with German drugmaker Boehringer Ingelheim. Fatty liver disease occurs when the body begins to store fat in the liver. It can progress to MASH, where fat buildup causes inflammation and scarring.
In a phase 2 trial in overweight or obese people, Boehringer Ingelheim’s survodutide, which uses both GLP-1 and glucagon, led to a 19% weight loss at 46 weeks. Another phase 2 study in people with MASH and fibrosis found that 83% of participants also had improvement in MASH.
Survodutide has significant potential to “make a significant difference to people with cardiovascular, renal and metabolic conditions,” said Dr. Waheed Jamal, corporate vice president of Boehringer Ingelheim and head of cardiometabolic medicine.
On Friday, the company released two studies on the drug. One person found, in hamsters, that weight loss was associated with improvements in insulin and cholesterol. The latter found that in people with Type 2 diabetes or obesity, the drug helped improve blood sugar levels.
The company wants to start a phase 3 trial.
This article was originally published on NBCNews.com
