Another win for semaglutide
While I don’t find this surprising, it underscores the power of modern pharmacology. Many drugs deliver only incremental improvement, but semaglutide–like anti-hypertensives and statins–looks transformative for many people.
“The diabetes and weight loss drug semaglutide significantly reduced symptoms and improved quality of life in people with obesity and the most common form of heart failure in a clinical trial, potentially expanding the already wildly popular drug’s use beyond diabetes and weight loss and offering a new treatment option where few are available.
“The study of 529 patients, funded by drugmaker Novo Nordisk, found that a 2.4-milligram weekly dose of semaglutide, sold as Wegovy for weight loss, led to an improvement of 17 points on a 100-point scale that’s used to assess symptoms of a condition known as heart failure with preserved ejection fraction. By comparison, participants who got a placebo had a 9-point improvement. The study was published Friday in the New England Journal of Medicine.”
Semaglutide and heart failure
I know modern pharma has a lot of problems, but there have been some pretty impressive breakthroughs recently. I recently read Breath From Salt about the development of drugs to manage cystic fibrosis and was pretty impressed. On a personal level, I started using Dupixent, and for the first time ever something has dramatically improved my eczema. No more blood around the collar. Wegovy is pretty amazing too. The prices of some of these drugs are insane, but the price of developing them is insane too, and it’s worse when one considers that so many new drugs are failures.
In Breath From Salt, they told how the Cystic Fibrosis Foundation sold the future royalty stream for the aerosol antibiotic they had funded for several hundred million dollars. They took a big chance with Kalydeco and used that money to develop a way to manufacture the drug in parallel with the phase 3 trials. That sounds like an insane amount of money to develop a manufacturing process, but then I read a paper by the process chemists at Pfizer who had come up with a way to manufacture paxlovid. It was a crash program taking a bit over a year. They had to come up with several alternate approaches to deal with potential supply chain issues. It was a heroic piece of work. It probably cost an insane amount of money.
https://www.nytimes.com/2023/08/17/health/weight-loss-drugs-obesity-ozempic-wegovy.html
August 17, 2023
We Know Where New Weight Loss Drugs Came From, but Not Why They Work
The empty auditoriums, Gila monsters, resistant pharmaceutical executives and enigmas that led to Ozempic and other drugs that may change how society thinks about obesity.
By Gina Kolata
Every so often a drug comes along that has the potential to change the world. Medical specialists say the latest to offer that possibility are the new drugs that treat obesity — Ozempic, Wegovy, Mounjaro and more that may soon be coming onto the market.
It’s early, but nothing like these drugs has existed before.
“Game changers,” said Jonathan Engel, a historian of medicine and health care policy at Baruch College in New York.
Obesity affects nearly 42 percent of American adults, and yet, Dr. Engel said, “we have been powerless.” Research into potential medical treatments for the condition led to failures. Drug companies lost interest, with many executives thinking — like most doctors and members of the public — that obesity was a moral failing and not a chronic disease.
While other drugs discovered in recent decades for diseases like cancer, heart disease and Alzheimer’s were found through a logical process that led to clear targets for drug designers, the path that led to the obesity drugs was not like that. In fact, much about the drugs remains shrouded in mystery. Researchers discovered by accident that exposing the brain to a natural hormone at levels never seen in nature elicited weight loss. They really don’t know why, or if the drugs may have any long-term side effects.
“Everyone would like to say there must be some logical explanation or order in this that would allow predictions about what will work,” said Dr. David D’Alessio, chief of endocrinology at Duke, who consults for Eli Lilly among others. “So far there is not.” …
August 26, 2023
The N.Y.C. Neighborhood That’s Getting Even Thinner on Ozempic
Prescriptions for a new class of medications used for diabetes and weight loss are concentrated in the city’s wealthier, whiter and healthier neighborhoods.
By Joseph Goldstein
The Upper East Side is one of the city’s wealthiest and healthiest neighborhoods. It has one of the highest life expectancies, and among the lowest rates of diabetes and obesity in New York City. Now the neighborhood’s residents are getting even thinner.
Last year, about 2.3 percent of people living along a stretch of Manhattan that extended from the Upper East Side down to Gramercy Park were taking Ozempic, Wegovy or Mounjaro — injectable medications belonging to a breakthrough new class of weight loss and diabetes drugs, according to an analysis by Trilliant Health, a health care analytics firm.
That was the highest rate in New York City.
In some parts of Brooklyn, by contrast, where diabetes and obesity are far more prevalent, the usage rate of these medications was just over half of what it was in affluent parts of Manhattan, according to that analysis.
https://www.nytimes.com/2023/08/25/health/weight-loss-drug-heart-failure.html
August 25, 2023
Obesity Treatment Relieves Heart Failure Symptoms, Drugmaker’s Study Finds
The drug Wegovy eased issues for people with a type of heart problem, adding to the treatment’s benefits beyond weight loss.
By Benjamin Mueller
One of the leading new obesity drugs, Wegovy, eased symptoms and raised the quality of life of patients with obesity and a common type of heart failure, a study funded by the drug’s maker found, adding to the evidence that the medications can produce health benefits beyond weight loss.
The study, * published on Friday in The New England Journal of Medicine, evaluated the drug in people with a condition known as preserved ejection fraction in which the heart pumps normally but has lost the flexibility needed to fill with blood. The condition accounts for roughly half of all heart failure cases.
Patients given Wegovy in the trial showed greater improvements in physical fitness and in symptoms like fatigue and shortness of breath than those administered a placebo. The study, which included 529 participants and lasted for a year, was not designed to assess cardiac emergencies, but it found that 12 patients on the placebo and only one on Wegovy were hospitalized or required an urgent medical visit for heart failure.
The drug showed more pronounced relief of heart failure symptoms than other treatments, the study said….
* https://www.nejm.org/doi/full/10.1056/NEJMoa2306963
@ltr,
This is the same NEJM study I referenced in my post. The NYT link is paywalled.