The best obesity drugs do not exist yet

Ozempic is just the beginning of a new era of obesity treatment. A review published this week reviews the emergence of similar experimental drugs that are likely to be more effective in helping people lose weight.

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

Semaglutide It is a synthetic, long-acting version of GLP-1, a hormone that regulates hunger and insulin production, among other things. Developed by Novo Nordisk, semaglutide was first approved to treat type 2 diabetes in 2017 as Ozempic, then for obesity in 2021 as Wegovy. It’s not the first GLP-1 drug to reach the public, but semaglutide has been a game-changer in treating obesity. It has been shown to help people lose 10% to 15% of their weight in studies, which is much higher than the typical success achieved with diet and exercise alone, and even exceeds the typical results of older GLP-1 drugs.

However, Semaglutide isn’t the only new kid on the block. Eli Lilly Tirzepatide It mimics both GLP-1 and another hunger-related hormone called GIP, a powerful combination that allowed it to beat out semaglutide. In clinical trials, people who took tirzepatide lost up to 20% of their starting weight. There are dozens of other related obesity treatments in the pipeline as well, some of which have reached human testing and are expected to eclipse even tirzepatide.

The McGill researchers analyzed data from 26 randomized clinical trials of single-agent GLP-1 drugs, dual agonists like tiraspatide, and even triple-agonist drugs like retatrotide, which combines synthetic versions of three hormones linked to hunger: GLP-1, GIP, and glucagon. These trials included people who were obese but did not have type 2 diabetes.

As expected, they found that the drugs approved today were generally safe and effective, with tirzepatide currently achieving the best results (participants lost up to 17% of body weight after 72 weeks of treatment). But they also noted that retaretide performed better in a shorter period of time, with participants losing up to 22% of their body weight after just 48 weeks of treatment.

“We found that of the 12 GLP-1 drugs identified through our research, the largest average reductions in body weight were reported in randomized controlled trials of retareotide, tirzepatide, and semaglutide,” the researchers wrote in their paper. published Tuesday in Annals of internal medicine.

Retatrutide is being developed by Eli Lilly, and is currently being tested in Phase III trials — trials that will reach their conclusion by 2026. It won’t be the only newcomer arriving in the near future that could outperform today’s existing drugs.

Last year, for example, early trial results for the drug amicretin (developed by Novo Nordisk) emerged. Suggested It can provide greater weight loss than semaglutide and tirzepatide. Other pharmaceutical companies are working on competitors to Ozempic, such as Boehringer Ingelheim and Zealand Pharma’s dual agonist. survodutide. Expectations have become so high that Novo Nordisk stock actually decreased When it announced that its drug candidate CagriSema (a combination of semaglutide with the experimental drug cagrilintide) helped people lose just 22% of weight in a recent trial, instead of the expected 25%.

These medications are not without their drawbacks, of course. They typically cause gastrointestinal symptoms such as diarrhea and vomiting, and have been linked to rare but serious complications such as: Gastroparesis (stomach paralysis). Another major concern is their price, as semaglutide and tirzepatide often cost about $1,000 per month without insurance coverage (which private and public insurance companies often do not provide). This cost and increasing demand have fueled a Gray and black market For these drugs, with people turning to cheaper but less safe synthetic and counterfeit versions.

Some experts hope that the arrival of more GLP-1-related drugs will help reduce some of these problems, especially cost and insurance coverage. Whether that actually happens, we’ll have to see. But there will almost certainly be many more drugs coming to replace semaglutide and tirzepatide’s current crown as the best treatment for obesity.