What can’t Ozempic and Wegovy do?
The blockbuster semaglutide medication have seen unprecedented demand over the previous 12 months after research discovered that the drugs, initially developed for kind 2 diabetes, had been remarkably efficient in serving to individuals reduce weight. Sufferers misplaced a mean of 15 p.c of their physique mass in medical trials that launched a media and medical frenzy.
The hype prepare was out of the station and selecting up velocity. Ozempic grew to become (to the priority of medical professionals) the food plan drug of selection for the celeb set. Then extra information started pouring in, affirming that the medication weren’t solely serving to individuals reduce weight however bettering their prognosis for different weight-related medical issues that rank among the many commonest causes of loss of life in the USA: coronary heart assaults, stroke, and coronary heart failure. A examine partially funded by Novo Nordisk, the medication’ producer, estimated that the product may assist forestall as many as 1.5 million coronary heart assaults and strokes over 10 years.
However wait — there’s extra.
Semaglutide doesn’t immediately goal fatty tissue; it really works on the human mind to assist sufferers reduce weight by decreasing their cravings to eat. Researchers have begun to contemplate purposes that had nothing to do with the medication’s authentic objective. Scientists quickly introduced they had been exploring Ozempic’s potential for slowing down dementia and treating substance abuse dysfunction. Novo Nordisk is funding trials to deal with fibrosis for individuals with non-alcoholic fatty liver illness. Different clinicians say in addition they are eyeing the drug’s potential for treating polycystic ovary syndrome or PCOS, one of many main causes of infertility.
Then final week got here the information that semaglutide may, within the phrases of 1 researcher, “change the entire pure historical past of kind 1 diabetes.” A century in the past, the synthesis of insulin gave kind 1 diabetics an opportunity to guide an extended, more healthy life. Now a really small examine offered a glimpse of a future the place it won’t be wanted in any respect.
For drug makers, this seek for Ozempic’s different medical purposes is simply sensible enterprise. Earlier blockbuster medication have later been authorised for makes use of that appeared to have little to do with their authentic objective: Viagra was initially developed to be a blood strain drug.
Individuals who work in drug improvement typically speak about a “pipeline in a capsule” — “the notion of a molecule that is ready to deal with numerous totally different indications,” stated Darius Lakdawalla, a well being care economist who research the pharmaceutical trade on the College of Southern California.
With rivals to Ozempic and Wegovy already within the works, discovering new purposes for these medication is a technique for his or her producer to remain a step forward of the competitors.
However for sufferers, the firehose of recent medical findings and media hypothesis may really feel overwhelming. I spoke with a number of consultants to attempt to make sense of the hype. The image that emerges is of a drug with genuinely monumental potential — however loads of uncertainty forward.
Ozempic holds critical potential for addressing cardiovascular issues — if the well being system can afford it
Semaglutide’s utility in treating the various well being circumstances related to weight problems is intuitive. If sufferers can cut back their physique weight by 15 p.c or extra, they’ll normally decrease their blood strain and ldl cholesterol, thereby lessening the possibilities that they are going to have a coronary heart assault or a stroke.
“The truth that the medication result in substantial weight reduction and weight is tied to each end result below the solar, it’s no shock to me that they might add these outcomes in trials associated to the medication.” stated Stacie Dusetzina, a well being coverage professor at Vanderbilt College.
And, up to now, analysis supported by Novo Nordisk has borne out that premise. In early August, the corporate introduced that a big medical trial had discovered taking semaglutide decreased the chance of a serious cardiovascular occasion for obese or overweight sufferers 45 years or older by 20 p.c when in comparison with a placebo. (These findings had been preliminary; full outcomes will probably be launched later this 12 months.)
In late August, the New England Journal of Medication printed the outcomes of one other, smaller examine that examined how Wegovy affected individuals with the most typical type of coronary heart failure. The examine, which was additionally supported by Novo Nordisk, discovered that sufferers who took Wegovy had fewer signs, fewer bodily limitations, larger capability for train, and extra weight reduction than sufferers who took a placebo.
The lead researcher informed CNN that the outcomes had been “the biggest therapy profit we’ve ever seen” by these metrics.
Ozempic and Wegovy clearly maintain actual potential for treating cardiovascular circumstances, although analysis will proceed as a way to affirm these early findings. The larger query is value.
As I’ve beforehand written, well being insurers typically don’t pay for Ozempic and Wegovy. Medicare and Medicaid don’t cowl weight-loss medication as a rule, and most non-public well being insurers don’t both. If a affected person and their physician do suppose the drug needs to be lined, they could nonetheless have to satisfy sure circumstances (equivalent to requiring checks or different documentation) earlier than a well being insurer will comply with pay for the medication. With out insurance coverage, these medication value upward of $1,000 per thirty days — prohibitive for lots of sufferers who could profit from utilizing them.
Their potential to save lots of lives has been a part of the argument from medical doctors that insurers ought to pay up. However countervailing proof has sophisticated the controversy. Bloomberg reported on the finish of August on one other examine that concluded insurers could should spend as much as $1 million on the semaglutide medication at their present costs as a way to save a single life.
Nonetheless, the proof for Wegovy’s advantages for cardiovascular well being general appears sturdy.
Utilizing Ozempic to deal with different circumstances is extra speculative for now — however much more analysis must be completed
In an odd twist of science, semaglutide is exhibiting promise for a special variation of the illness for which it was first authorised six years in the past: diabetes.
Ozempic first got here onto the market in 2017 to deal with kind 2 diabetes, the extra widespread model of the illness that’s usually related to weight problems. For individuals with kind 2, insulin is usually however not at all times vital; food plan and train can go a good distance too. However for individuals who have kind 1 diabetes, which is rarer and tends to develop earlier in life, insulin has been a lifeline because it was first produced for human use 100 years in the past.
However Ozempic might be able to change that actuality too. In a small examine of 10 sufferers who had been lately identified with kind 1 diabetes, seven of them had been capable of cease taking any type of insulin inside six months. Their our bodies improved in producing insulin and their blood sugar was extra steady.
One of many lead researchers described the findings as “like science fiction.” However his friends added an vital caveat that applies to most of the extra adventurous purposes of Ozempic: “We want a way more rigorous examine to actually affirm the outcomes,” Dr. Daniel Drucker, a number one semaglutide researcher, informed CNN.
The identical is true for the drug’s potential for substance abuse and dementia.
Individuals who work in dependancy therapy say Ozempic and Wegovy have spurred plenty of dialog of their subject. However the proof isn’t there but. One examine involving mice, printed in 2021, discovered that utilizing an identical agent didn’t appear to affect cocaine use, however individuals who have taken semaglutide have self-reported decreased alcohol consumption.
Dementia is certainly one of a number of circumstances for which semaglutide’s potential to enhance cardiovascular well being might also contribute to different, much less apparent well being advantages. Coronary heart well being is a threat issue for dementia, and there are preliminary research from Denmark that counsel individuals on semaglutide had a decrease fee of dementia. Extra sturdy research at the moment are underway. Likewise, weight and coronary heart well being are related to threat for PCOS, which might result in irregular durations and infertility, and scientists are optimistic that Ozempic and Wegovy may result in higher well being outcomes for these circumstances too.
It’s an thrilling second and there are professional causes to be hopeful about Ozempic’s potential. However we’re nonetheless within the early chapters of this outstanding story. There’s a lengthy technique to go.
