The next wave of obesity drugs is coming soon.
Pharmaceutical companies are racing to develop GLP-1 drugs following the blockbuster success of Novo Nordisk’s Ozempic and Wegovy and Eli Lilly’s Mounjaro and Zepbound.
Some experimental drugs may go beyond diabetes and weight loss, improving liver and heart function while also reducing side effects such as muscle wasting seen with existing drugs. At the 2024 American Diabetes Association conference in Orlando, Florida, researchers are expected to present data on 27 GLP-1 drugs in development.
Dr. “We’ve heard of Ozempic and Mounjaro and the like, but now we’re seeing a number of different drug candidates on the pipeline, from very early preclinical to late-stage clinical,” Marlon said. Pragnell is the ADA’s vice president for research and science. “It’s very exciting to see so much right now.”
The majority of the data presented comes from animal studies or early-stage human trials. However, according to the list shared by the organization, some presentations include mid- and advanced-stage trials.
Food and Drug Administration approval is likely years away for most. Some of the drugs on display may become available by prescription in the United States within the next few years.
D., a gastroenterologist who runs a weight-loss clinic in Cary, North Carolina. “We have witnessed an unprecedented acceleration in the development of GLP drugs,” said Christopher McGowan. “We are now firmly committed to the GLP era.”
McGowan added that although existing drugs are highly effective, new drugs that are more affordable and have fewer side effects are needed.
There are not just GLP-1 drugs in the pipeline. On Thursday, ahead of its diabetes conference, Denmark-based biotech firm Zealand Pharma released data showing that high doses of the experimental weight-loss drug petrelintide helped reduce body weight by an average of 8.6% in 16 weeks.
The weekly injectable medication is unique because it mimics the hormone amylin, which helps control blood sugar. It is hoped that patients will experience fewer side effects, such as nausea, that are often associated with GLP-1 drugs such as Wegovy and Zepbound.
Can the hormone glucagon help with weight loss?
GLP-1 drugs work partly by slowing the rate at which food passes through the stomach, making people feel full for longer. Many of the upcoming weight loss medications feature a different hormone called glucagon. Glucagon is an important hormone that regulates blood sugar, which can mimic the effects of exercise.
One of the drugs featured at Sunday’s conference was called pemvidutide, from Maryland-based biotechnology company Altimmune.
In addition to glucagon, the drug also contains the hormone GLP-1, which is the main component of Ozempic and Wegovy.
Altimmune released data from its phase 2 trial of 391 adults who had obesity or were overweight and had at least one weight-related comorbidity, such as high blood pressure. Patients were randomized to receive three doses of pemvidutide or placebo for 48 weeks.
Researchers found that patients taking the highest dose of the drug lost an average of 15.6% of body weight after 48 weeks, compared with the 2.2% body weight loss seen in patients taking a placebo. In similar trials, semaglutide was shown to reduce body weight by approximately 15% after 68 weeks.
These are not direct comparisons because the drugs were not compared head-to-head in a clinical trial.
Altimmune’s chief medical officer, Dr. Scott Harris said the drug has been shown to provide health benefits to the liver and heart, as well as helping people lose weight. Moreover, the drug was also found to be beneficial in preserving lean body mass. Some studies suggest that semaglutide, the active ingredient in Ozempic and Wegovy, may cause muscle wasting.
“If people use drugs long-term, what will happen to their long-term health? What will be the long-term effects on their body composition, their muscles, and their ability to function?” said.
People taking pemvidutide lost an average of 21% of their lean body mass, which is less than the about 25% of lean body mass people typically lose with diet and exercise, Harris said.
“We are the next wave of obesity drugs,” said Vipin Garg, President and CEO of Altimmune. “The first wave of mechanisms was all about appetite suppression. We’re adding another component.”
Altimmune expects to begin its phase 3 trial soon. The company hopes to have the drug available in the United States in 2028.
Competition can reduce costs
Experts say increasing the number of weight-loss medications available is important for several reasons.
More options could also help address shortages seen in the U.S. of weight-loss drugs from Novo Nordisk and Lilly.
Increased competition may reduce the high cost of drugs over time. A one-month supply of Wegovy or Zepbound can cost more than $1,000, making it financially unsustainable for most patients, experts say.
Associate professor of medicine and pediatrics at Harvard Medical School. Fatima Cody Stanford said patients may respond differently to treatments. In fact, some have found existing GLP-1 options to be ineffective.
“Different GLP-1 drugs may have different levels of efficacy and potency,” he said. “Some patients may respond better to one drug than another depending on how their body metabolizes and responds to the drug.”
Since starting Ozempic in June 2022, Danielle Griffin has not seen the results her doctor predicted. “He expected to see a really big difference in my weight, but I never saw it,” said the 38-year-old from Elida, New Mexico. Griffin weighed about 300 pounds and lost only 10 pounds in two years. “His expectations were pretty shattered by this,” she said.
Due to insurance wars and shortages, she also tried Wegovy and Mounjaro but saw no difference in her weight.
“I don’t think there are options, especially for myself, for someone where medications don’t work.”
Griffin is excited about the possibility of new drugs on the horizon. “I would love to try this,” he said, adding: “Honestly it could change my life and you know it gives me something to look forward to.”
More drugs on the way
Eli Lilly, which makes Zepbound and its diabetes version Mounjaro, has two other GLP-1 drugs in development.
Lilly on Sunday released new data on 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 a previous trial, retatrutide helped people lose an average of 24% of their body weight; which was equivalent to about 58 pounds; this was more weight loss than any other drug on the market.
The new findings showed that the weekly medication also significantly reduced blood sugar levels in people with Type 2 diabetes.
On Saturday, new findings regarding the experimental mazdutide developed by Lilly in partnership with the Chinese biotechnology company Innovent Biologics also emerged. The drug combines GLP-1 and glucagon.
In a phase 3 study of adults with overweight or obesity in China, researchers found that a 6-milligram dose of the drug led to an average 14.4% body weight reduction after 48 weeks.
Director of Peking University Diabetes Center, Dr. According to Linong Ji, the drug also led to a decrease in serum uric acid, a chemical that can accumulate in the bloodstream, causing health problems and has been associated with obesity. Results.
He said in an interview that this was “quite unique and has never been reported for other GLP-1-based therapies.”
Ji said the drug could be approved in China in 2025.
Improving 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 at German drugmaker Boehringer Ingelheim. Fatty liver disease occurs when the body begins to store fat in the liver. It can progress to MASH when fat accumulation causes inflammation and scarring.
In a phase 2 trial in people with overweight or obesity, Boehringer Ingelheim’s survodutide, which uses both GLP-1 and glucagon, led to 19% weight loss in 46 weeks. Another phase 2 study in patients with MASH and fibrosis found that 83% of participants also showed improvement in MASH.
Boehringer Ingelheim’s corporate vice president and head of cardiometabolic medicine, Dr. Waheed Jamal said Survodutide “has the potential to make a meaningful difference for people living with cardiovascular, renal and metabolic conditions.”
On Friday, the company released two studies on the drug. A study in hamsters found that weight loss was associated with improvements in insulin and cholesterol. Second, the drug was found to help improve blood sugar levels in people with Type 2 diabetes or obesity.
The company plans to start the phase 3 trial.
This article first appeared on NBCNews.com.