The popularity of drugs like Ozempic and Mounjaro could grow exponentially in the coming years, both for weight loss and for a growing list of potential uses that are being studied.
GLP-1 agonists, a class of drugs typically used to treat type 2 diabetes and obesity, have been available since 2005, but only in recent years have they transformed weight loss treatment, as well as generating billions for the companies that produce the drugs. KFF Health Policy Research Group research from earlier this year found that 1 in 8 adults have ever taken a GLP-1 agonist and 6% of adults are currently on the regimen.
Medications such as semaglutide, tirzepatide and dulaglutide, marketed as Ozempic, Mounjaro and Trulicity respectively, fall into this class of medications.
They work by mimicking a hormone produced by the body – glucagon-like peptide-1 – which stimulates insulin secretion and reduces appetite. These medications are currently prescribed for the treatment of diabetes and obesity, but early research points to possible benefits for a multitude of other conditions.
These include clinical trials looking at the drug’s potential use in treating diseases such as Alzheimer’s disease and liver disease.
According to Marijane Hynes, founder of the George Washington University School of Medicine Weight Loss Clinic, the mechanism by which GLP-1 can treat conditions outside of obesity and diabetes is not yet well understood.
“We don’t know exactly how all these things work so well, but it must hit an addiction center in the brain,” Hynes said of some of the side effects he’s seen, noting how his patients report a cessation of the “eating noise.” constant and recurring thoughts about food when they start taking GLP-1 medications.
Here are some conditions for which medications like Ozempic may be prescribed in the future:
Addiction
A rodent study published last year found that semaglutide use was associated with reduced binge drinking in rats. Researchers theorized that this was due to the drug targeting parts of the brain associated with binge eating, which also overlap with the desire to ingest substances such as alcohol.
Interestingly, Hynes observed a similar phenomenon among “many patients.”
“I see people who drink, you know, a bottle a day stop drinking with this stuff,” she said.
Brianna Johnson-Rabbett, an endocrinologist and obesity medicine physician at Nebraska Medicine, echoed these observations, noting that her patients “don’t really have any desire to drink alcohol and that…certainly has a very positive benefit.”
One analysis published in Annals of Internal Medicine last month found an association between semaglutide and a lower rate of prescriptions and smoking cessation counseling.
Neurodegenerative diseases
Novo Nordisk is currently conducting a multinational Phase 3 study to see whether semaglutide has a positive effect on early Alzheimer’s disease. The trial is currently set to end in 2026.
Some small studies have indicated a positive effect between GLP-1s and cognitive decline. The conclusions of a study carried out in the United Kingdom were recently presented in Alzheimer’s Association International Conference.
The study, which looked at the use of another GLP-1 agonist called liraglutide, involved 204 patients with Alzheimer’s disease. Researchers observed an 18% slower cognitive decline over a year compared to trial participants who took a placebo.
According to Paul Edison, study leader and professor of science at Imperial College London, “Although more research is needed, liraglutide may work through several mechanisms, such as reducing inflammation in the brain, decreasing insulin resistance and toxic effects. of Alzheimer’s biomarkers amyloid-beta and tau, and improving the way nerve cells in the brain communicate.”
This study has not yet been peer-reviewed.
O one year resultsA phase 2 study published in The New England Journal of Medicine this year found that another GLP-1 agonist called lixisenatide, made by Sanofi, was associated with less progression of motor disability among people with Parkinson’s disease.
Heart disease
Earlier this year, the Food and Drug Administration approved Wegovy, a form of semaglutide originally indicated for the treatment of obesity, to reduce the risk of cardiovascular death, heart attack and stroke in patients with cardiovascular disease and obesity.
This marked the first time that a weight loss drug was approved specifically for treating heart disease. Subsequent discoveries further supported the use of these medications in supporting cardiovascular health.
Eli Lilly published discoveries last week of a Phase 3 trial that found that tirzepatide, the active ingredient in Mounjaro, reduced the risk of heart failure by 38 percent when compared with a placebo.
According to Johnson-Rabbett, the benefits seen in these studies are likely a combined result of the weight loss caused by taking the GLP-1 agonist, as well as a separate mechanism that has not been fully determined.
“We have evidence that there are GLP-1 receptors present in the heart and blood vessels. This could explain some of the evidence, for example, on the risk of serious cardiovascular events,” said Johnson-Rabbett.
“We have evidence of effects on inflammation that, you know, again are potentially due in part to effects on weight, but [there is] some evidence of specific effects on the body’s inflammatory cells. So, it’s very exciting,” she added.
Kidney disease
A study published this year in The New England Journal of Medicine found that using semaglutide may help reduce the risk of kidney failure in people with type 2 diabetes and chronic kidney disease.
Also funded by Novo Nordisk, this study found that kidney disease events were 24% lower in the semaglutide group than in the placebo group.
This trial was stopped earlier than expected, with the company stating that the results already met “certain pre-specified criteria”.
Eli Lilly, the maker of Mounjaro, is also conducting its own study to see if its GLP-1 product can help overweight or obese people who also have kidney disease.
Liver disease
Conclusions presented at the Conference on Retroviruses and Opportunistic Infections earlier this year noted a 31 percent reduction in liver fat in people with HIV and steatotic liver disease associated with metabolic dysfunction (MASLD) after taking semaglutide.
HIV can often affect the liver, leading to the accumulation of fat in the organ. This, in turn, can cause scar tissue and inflammation, potentially resulting in cirrhosis. MASLD, formerly known as non-alcoholic fatty liver disease, is characterized by an excessive accumulation of fat in the liver not caused by alcohol consumption or hepatitis.
The use of semaglutide resulted in 29 percent of study participants experiencing complete resolution of MASLD.
Novo Nordisk is conducting another Phase 3 study to investigate whether semaglutide can help in the treatment of steatohepatitis associated with metabolic dysfunction, the advanced form of MASLD.
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