The best obesity drugs are still not here

Ozempic is just the beginning of a new era of obesity treatment. A study published this week predicts the emergence of similar experimental drugs that will be even more effective in helping people lose weight.

McGill University researchers conducted a review of clinical trial data involving GLP-1 drugs such as semaglutide (the active ingredient in Ozempic and Wegovy). Researchers have reaffirmed the safety and effectiveness of today’s drugs. But they also highlighted the potential advantage of new compounds currently in development, such as retatrutide, which has so far helped people lose more than 20% of their original body weight in trials.

Semaglutide it is a synthetic and longer-lasting version of the hormone GLP-1, a hormone that regulates hunger and insulin production, among other things. Semaglutide, developed by Novo Nordisk, was first approved in 2017 as Ozempic for type 2 diabetes and then in 2021 as Wegovy for obesity. It is far from the first GLP-1 drug to reach the public, but semaglutide has been a game changer for the treatment of obesity. In studies, it has been shown to help people lose 10%-15% of their weight, which is much higher than the typical success seen with diet and exercise alone, and even surpasses the typical results of older GLP-1 drugs.

Semaglutide isn’t the only new kid on the block. Eli Lilly’s tirzepatide mimics both GLP-1 and another hunger-related hormone called GIP—a potent combination that allows it to dethrone semaglutide. In clinical trials, people taking tirzepatide lost 20% of their initial weight. There are dozens of other related obesity treatments in the pipeline, some of which have been tested in humans and are even poised to eclipse tirzepatide.

McGill researchers analyzed data from 26 randomized clinical trials of single-agent GLP-1 drugs, dual agonists such as tirzepatide, and even triple agonist drugs such as retatrutide, which combine synthetic versions of three hunger-related hormones: GLP-1, GIP, and glucagon. These trials involved people living with obesity but without type 2 diabetes.

As expected, they found that today’s approved drugs are generally safe and effective, with tirzepatide currently performing the best (participants lost up to 17% of their body weight after 72 weeks of therapy). But they also noted that retatrutide performed better in the shorter term, with participants losing 22% of their body weight after just 48 weeks of therapy.

The researchers wrote in their paper, “In our search, we found that among the 12 GLP-1 (drugs) identified, the greatest mean body weight reductions were reported in randomized controlled trials of retatrutide, tirzepatide, and semaglutide. has been published Tuesday Annals of Internal Medicine.

Retatrutide is being developed by Eli Lilly and is currently being tested in phase 3 trials that will be completed by 2026. And it won’t be the only newcomer that could outperform today’s existing drugs in the near future.

Last year, for example, the first trial results of amicretin (made by Novo Nordisk). suggested may provide greater weight loss than semaglutide and tirzepatide. Other drug companies are working on their own rivals to Ozempic, such as a dual agonist from Boehringer Ingelheim and Zealand Pharma. pressure cookers. Expectations were so high that shares of Novo Nordisk actually fell when they announced that their drug candidate CagriSema (a mix of semaglutide with the experimental drug cagrilintide) only helped people lose 22% of their weight in a recent trial, rather than the expected 25%.

These drugs, of course, are not free from negative aspects. They usually cause gastrointestinal symptoms such as diarrhea and vomiting and are associated with rare but serious complications. gastroparesis (gastric paralysis). Another major concern is their cost, with semaglutide and tirzepatide often costing about $1,000 a month without insurance coverage (often not covered by private and public insurers). This cost and increased demand has fueled a gray and black market For these drugs, people turn to cheaper but less safe compound and fake versions.

Some experts hope that the arrival of more GLP-1 related drugs will help alleviate some of these issues, particularly cost and insurance coverage. We’ll have to see if that actually happens. But there will be plenty of drugs coming for the current crown of semaglutide and tirzepatide as arguably the best obesity treatment.