Eli Lilly’s Tirzepatide Weight Loss Drug Effective in New Trial

Image for article titled Experimental Drug for Weight Loss Shows Surgery-like Results in a New Trial

photo: Darron Cummings (AP)

The pharmaceutical company Eli Lilly last week disclosed the latest data from a phase III trial of his experimental drug for type 2 diabetes and obesity, tirzepatide: people who took the drug lost up to 22% of their body weight and achieved a loss of much greater weight on average than the placebo group. The findings, although preliminary, suggest that tirzepatide may become the second major drug in a new era of obesity treatments, as long as patients can afford it.

The SURMOUNT-1 study included more than 2,500 overweight (defined as body mass index between 25 and 30) or obese (BMI over 30) patients, and they also had a disease possibly related to their weight, with the exception of of diabetes. . These patients were randomized to receive a placebo or one of three different doses of tirzepatide, delivered weekly by subcutaneous injection. In addition to treatment, each group was advised to go on a low-calorie diet and increase their physical activity. The test was conducted in the US, Argentina, Brazil, China, India, Japan, Mexico, Russia and Taiwan.

Each group lost weight on average over 72 weeks, but the loss was much greater in the tirzepathid groups. Those who received a dose of 5 milligrams lost an average of 15% body weight; those who took a dose of 10 milligrams lost 19.5% and those who took the dose of 15 milligrams lost 20.9%, compared to 3.1% weight loss observed in the placebo group. When people who dropped out of the study early were counted, the study’s researchers estimated that people with the highest dose lost an average of 22% of their body weight, or about 50 percent. free. Adverse effects were generally mild to moderate, but included nausea, vomiting, and diarrhea, which often occurred at first when people’s doses increased.

The findings have not yet been published in a peer-reviewed journal, so they should be taken with some caution. But the figures seen here, assuming they are solid, are simply unprecedented for a drug, according to Samantha Harris, an endocrinologist at the Scripps Clinic who focuses on weight management and diabetes care.

“The ability to lose 15%, 20% or 25% of your total body weight with medication is amazing, as these results are usually only seen in patients who have undergone bariatric surgery,” he said. said Harris in an email to Gizmodo.

Last June, He won the Noveg Nordisk Wegovy approval of the Food and Drug Administration for the treatment of obesity. Wegovy is a higher dose version of semaglutide, the same active ingredient used in its Ozempic and Rybelsus type 2 diabetes medicines. Wegovy’s baseline trials showed that patients lost an average of 15% of their body weight, figures that now match or exceed tirzepatide.

Both semaglutide and tirzepatide work by essentially increasing the levels of a hormone called GLP-1. But tirzepatide also raises the levels of a second hormone called GIP (a glucose-dependent tropic insulin polypeptide). These incretins, as they are known, play a crucial role in regulating our metabolism and appetite. And the combination of GLP-1 and GIP activity observed with tirzepatide could very well explain its superiority over semaglutide in trials so far, Harris said.

Incretin-based drugs have been shown to be valuable and safe treatments for type 2 diabetes for over a decade, especially through increased insulin production that helps control blood sugar. But the continued success we are seeing with these drugs outside of diabetes could be just the beginning, according to obesity specialist Michael Albert. Patients who take them also have them improvements shown in cardiovascular health, for example, and some studies have even done so suggested they could provide a protective effect against dementia, although more research will be needed there to confirm the benefits.

“I think we’re seeing a new era of therapeutics here. And these drugs will really make a significant difference in our fight against many of these chronic diseases that we’ve really struggled to overcome,” Albert told Gizmodo by phone.

As promising as these drugs are, some critics have done so questioned the inherent value of anti-obesity treatments, especially given their irregular overall history. Another urgent issue, even for those who want to take these treatments, has been affordability. Wegovy’s pocket price is about $ 1,400 a month, and neither he nor other obesity treatments are eligible to be covered by basic Medicare plans. Many private insurers have also refused to cover Wegovy. And since last year, Novo Nordisk has faced a shortage of manufacturing, which has made it even more difficult for new patients to obtain medication.

“The drugs seem great, but Wegovy is expensive, and so are the others,” said Stephan Guyenet, a neuroscience researcher, author and editor of reviews at Frontiers in Nutrition, in an email to Gizmodo. “This is especially true in the US, where Wegovy costs about four times as much as in other countries. So the main question becomes access.”

New Nordisk tea dit that their factory problems will clear up during the second half of the year. From the results of previous tests, Eli Lilly had already done so presented tirzepatide for FDA approval as a treatment for diabetes late last year, and a decision on that indication is expected before the end of the second trimester. Eli Lilly will almost certainly present the drug for approval as a treatment for obesity, although no clear timetable has yet been set.

Assuming the results of tirzepatide are up to par, we will probably have two of these next-generation drugs available next year and others, even more effective. therapies could continue for the next decade. This competition could drive down prices, or at least strengthen the case for widespread coverage.

“My only major concern is, how is access to these drugs? Are they covered in the long run?” said Albert. “If we get the coverage part, which I think will come with more momentum around data reporting, the sky is the limit. And I think for patients who will benefit from these treatments, there’s real hope in the horizon “.

One way or another, these drugs are likely to change the conversation to one that focuses less on personal choices and more on the metabolic foundations of obesity.

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