Weight loss and much more

The last 7-8 years have been a remarkably productive time for the pharmaceutical industry.

In addition to vaccines that saved countless lives during the pandemic, there have been stem cell advances, breakthroughs in Alzheimer’s treatment and vaccines that selectively target cancer. Recently a new class of non-opioid painkillers was discovered.

Against this backdrop is the increasing use of artificial intelligence to map development of new drugs. Within years, AI is expected to halve the time from discovery to market, with a corresponding savings in cost.

Exciting times indeed.

And nowhere is the excitement greater than with the highly publicized weight-loss drugs. Oprah and the soap stars love them, and the medicines hold out hope for treating a whole range of maladies. I’m talking about Novo Nordisk’s Ozempic and Wegovy (semaglutide) and Eli Lilly’s Mounjaro and Zepbound (tirzepatide).

Their history is fascinating.

For decades, Novo Nordisk and Eli Lilly have produced insulin for Type 1 diabetes. (I have a granddaughter who’s a customer.) From there it was a short jump to Type 2 diabetes, a disease greatly worsened by obesity. Hence the attention to weight-loss drugs.

Semaglutide, tirzepatide and analogs work by activating the GLP-1 and/or GIP hormone receptors. That signals the pancreas to produce insulin. It also mimics hormones the body releases when we eat, curbing appetite.

None of this is new. GLP-1 drugs have been around for decades. The problem was the early versions weren’t very good, reducing weight by only about 8%.

Ozempic, which hit the market in 2019, followed by Wegovy in 2021 and the Eli Lilly products shortly thereafter, changed all that and kicked off the so-called “paradigm shift” in obesity treatment.

Here’s why. As reported by Dr. Angela Fitch, president of the Obesity Medicine Association, treatment with tirzepatide yielded a 20% weight reduction in an unprecedented 60% of trial participants. Earlier clinical testing with semaglutide delivered an average 16% weight loss. According to Dr. Fitch, those results were life-changers, giving hope to the 750 million people worldwide who are living with obesity, many having already exhausted all other ways of slimming down.

Current treatment requires weekly shots, although last month Novo Nordisk reported promising results with pills. Adding convenience, Eli Lilly now makes Zepbound available by Amazon delivery, although a doctor’s prescription is still needed. Some Medicare members can offset costs for Wegovy, as government steps in to make the drug more affordable.

And weight loss may be just the tip of the iceberg. A 17,000-patient semaglutide trial revealed a 20% reduction in heart attacks among patients with a history of cardiovascular disease. The FDA was impressed and approved use of Wegovy for reducing risk of cardio events, including strokes.

And there’s more. Early testing showed the GLP-1 drugs may also curb craving for alcohol – a godsend for treating alcoholics, if verified.

Overpromising is always risky, and all of the players are careful not to claim too much. Dr. Evelina Grayver, a women’s heart care specialist, spoke for them all when she said, “There is no such thing as a miracle drug … Lifestyle is the foundation of it all.” Stay active, she said, exercise, watch your diet, refrain from smoking and get plenty of rest.

That sets the stage for the GLP-1 drugs to knock it out of the park. At this writing they’ve done that and more. And, we are told, there are others just like them in the pipeline.

Dave Trecker, Ph.D., is a chemist and retired Pfizer executive living in Naples.

This article originally appeared on Fort Myers News-Press: Weight loss and much more