As extra medical doctors and sufferers flip to the most recent weight-loss medication, researchers are attempting to determine which drug is correct for which affected person—and at what level of their weight-loss journey.
Key to creating these choices is how efficient the medication are and which negative effects individuals may expertise whereas taking them.
A brand new study revealed within the New England Journal of Drugs and introduced on the European Congress on Weight problems gives 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 initial findings have been launched in Dec. by Eli Lilly, who funded the research. The present report contains extra particulars on how the 2 medication affected waist circumference and different measures, in addition to their negative effects.
Among the many 751 individuals 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 comparable negative effects, primarily referring to gastrointestinal signs together with nausea, constipation, diarrhea, and vomiting. Nevertheless, these taking Zepbound reported extra injection-site reactions than individuals getting Wegovy. These tended to turn into much less frequent with further weekly injections.
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“The thought right here is that we didn’t have choices earlier than—or we had very dangerous choices—and now now we have higher and higher therapies, and they’re totally 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 research.
Whereas the first goal for these remedy is weight reduction, it’s not the one metric by which the medication ought 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 nicely, 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 just isn’t the one end 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 authorised by the U.S. Meals and Drug Administration to scale back the danger of coronary heart assault, stroke, and coronary heart illness in individuals 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 embody a heart-disease indication, however research have proven that Zepbound, in addition to Wegovy, can reduce the risk of heart failure in some sufferers with the situation. Research are additionally displaying that the medication can scale back the danger of liver and kidney signs as nicely. And Zepbound is authorised to scale back the danger of obstructive sleep apnea in individuals with weight problems.
The present findings ought to assist medical doctors higher perceive which drug is likely to be proper for which affected person. Further research that each firms are conducting—together with these following individuals as soon as they’ve reached their weight-loss objectives—must also present extra knowledge on how these medication may assist individuals preserve a wholesome weight. Each Lilly and Novo Nordisk additionally plan to have oral variations of their injectable medication accessible quickly. Novo Nordisk announced it had requested FDA approval for its oral semaglutide in Might, and Lilly expects to have outcomes from its remaining trials in a number of months; if these are constructive, it plans to use for approval quickly after. Oral variations of those medication may attain extra individuals who may profit from them, and the capsules may be thought-about 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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