At the annual meeting of the European Association for the Study of Diabetes (EASD) in Milan, researchers from the pharmaceutical companies behind the most popular weight-loss medications reported encouraging results from studies of a new group of injectable medications that may come with fewer side effects.
Scientists from Novo, which makes Wegovy and Ozempic, reported this week that their experimental amylin-based compound CagriSema, taken as a weekly injection, helped people who were overweight or obese lose 22.4% of their starting body weight after a year compared to those taking a placebo. The company also reported on fMRI studies of the brain that showed CagriSema changed brain responses to food, potentially making food fixations less intense. And in people with Type 2 diabetes, the drug reduced the amount of harmful fat in the liver and pancreas, an early but encouraging sign that the medication may contribute to health benefits beyond those associated with weight loss. CagriSema is a combination of the semaglutide—the active ingredient in Wegovy and Ozempic—with cagrilintide, an amylin analogue that mimics a hormone made in the pancreas that regulates feelings of being full.
Researchers from Eli Lilly, which makes Zepbound (tirzepatide), reported that EloraTZP, its experimental combination drug of the amylin analogue eloralintide and tirzepatide, helped people who were overweight or had obesity and also had Type 2 diabetes to lose 23% of their starting body weight compared to 14.8% among those using tirzepatide alone after nearly a year. The weekly injectable also helped people to lower A1C, a measure of diabetes, by more than either tirzepatide or the amylin compound alone. The company has been studying the amylin part of the combination on its own, but plans to study the combination in additional studies beginning this year.
Because of their efficacy and favorable side-effect profile, at least in experiments, amylin-based medications may one day be an attractive first-line therapy for many people who are looking to lose a moderate amount of weight without the unpleasant side effects associated with the GLP-1 group of weight-loss drugs. “The amylins still cause some nausea, but it’s at less than half the rate of what we generally see in GLP-1 trials,” says Dr. Timothy Garvey, professor in nutrition sciences and senior scientist in the nutrition obesity research center at University of Alabama who led the petrelintide trial. Not everyone needs drastic weight loss, he says, so amylin drugs could be a welcome option for them. “As more of these tools become available, we can individualize care better,” he says. “Primary care physicians may have an easier time prescribing these since they are better tolerated. So I am personally very sanguine about amylins.”
Novo has submitted a request to the U.S. Food and Drug Administration for approval of CagriSema to treat overweight and obesity in people without diabetes, and the agency is expected to make a decision by the end of the year. The other products are in earlier human testing stages, but the results suggest that amylins may someday join GLP-1s in the burgeoning category of weight-loss drugs.
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