As extra medical doctors and sufferers flip to the newest weight-loss medicine, researchers are attempting to determine which drug is true for which affected person—and at what level of their weight-loss journey.
Key to creating these choices is how efficient the medicine are and which unintended effects folks would possibly expertise whereas taking them.
A brand new examine printed within the New England Journal of Drugs and offered on the European Congress on Weight problems offers a few of these solutions. Researchers report on a head-to-head trial evaluating Wegovy (semaglutide), made by Novo Nordisk, to Zepbound (tirzepatide), made by Eil Lilly. The preliminary findings have been launched in Dec. by Eli Lilly, who funded the examine. The present report consists of extra particulars on how the 2 medicine affected waist circumference and different measures, in addition to their unintended effects.
Among the many 751 folks randomly assigned to obtain weekly injections of both the utmost dose of Wegovy or the utmost dose of Zepbound for a 12 months and three months, these taking Zepbound misplaced extra of their preliminary physique weight—20.2%—than these taking Wegovy, who misplaced 13.7%. The Zepbound group misplaced about 18.4 cm of their waist circumference, in comparison with 13.0 cm amongst these taking Wegovy.
The medicines had related unintended effects, primarily referring to gastrointestinal signs together with nausea, constipation, diarrhea, and vomiting. Nevertheless, these taking Zepbound reported extra injection-site reactions than folks getting Wegovy. These tended to grow to be much less frequent with further weekly injections.
Learn Extra: How a New Weight-Loss Tablet May Rework Well being
“The thought right here is that we didn’t have choices earlier than—or we had very dangerous choices—and now we’ve got higher and higher therapies, and they’re completely different,” says Dr. Leonard Glass, senior vp of world medical affairs for Lilly’s cardiometabolic well being enterprise, and one of many co-authors of the examine.
Whereas the first goal for these treatment is weight reduction, it’s not the one metric by which the medicine needs to be evaluated and prescribed. Glass factors out that weight problems is a posh situation, and other people with weight problems typically produce other well being points as properly, associated to the guts, kidney, and liver. “It’s not nearly weight,” he says.
Dr. Jason Brett, principal U.S. medical head for Novo Nordisk, which makes Wegovy, agrees that weight will not be the one final result that medical doctors and sufferers ought to take into account when evaluating the 2 medicines. He notes that Wegovy—not like its competitor—is authorized by the U.S. Meals and Drug Administration to scale back the chance of coronary heart assault, stroke, and coronary heart illness in folks with a historical past of coronary heart issues who’re chubby or overweight. “After I take into consideration what makes semaglutide and Wegovy distinctive, it’s the breadth and depth of information behind it,” he says. “We’re speaking about going past weight reduction alone to a few of these different well being outcomes.”
Zepbound doesn’t embrace a heart-disease indication, however research have proven that Zepbound, in addition to Wegovy, can cut back the chance of coronary heart failure in some sufferers with the situation. Research are additionally displaying that the medicine can cut back the chance of liver and kidney signs as properly. And Zepbound is authorized to scale back the chance of obstructive sleep apnea in folks with weight problems.
The present findings ought to assist medical doctors higher perceive which drug could be proper for which affected person. Further research that each firms are conducting—together with these following folks as soon as they’ve reached their weight-loss objectives—also needs to present extra information on how these medicine might assist folks keep a wholesome weight. Each Lilly and Novo Nordisk additionally plan to have oral variations of their injectable medicine accessible quickly. Novo Nordisk introduced it had requested FDA approval for its oral semaglutide in Might, and Lilly expects to have outcomes from its remaining trials in a couple of months; if these are constructive, it plans to use for approval quickly after. Oral variations of those medicine might attain extra individuals who would possibly profit from them, and the drugs may be thought of a part of upkeep remedy relying on their particular person wants. “Proper now, [those decisions] are primarily based on doctor expertise, and typically not essentially on the very best proof,” says Glass. “We are attempting to supply that proof so medical doctors and sufferers can higher make these choices.”
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