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 selections is how efficient the medicine are and which unwanted effects folks may expertise whereas taking them.
A brand new examine revealed within the New England Journal of Drugs and offered on the European Congress on Weight problems supplies 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 unwanted 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 unwanted effects, primarily regarding gastrointestinal signs together with nausea, constipation, diarrhea, and vomiting. Nonetheless, these taking Zepbound reported extra injection-site reactions than folks getting Wegovy. These tended to develop into much less frequent with further weekly injections.
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“The concept right here is that we didn’t have choices earlier than—or we had very dangerous choices—and now we now have 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 remedy is weight reduction, it’s not the one metric by which the medicine ought to be evaluated and prescribed. Glass factors out that weight problems is a fancy situation, and other people with weight problems usually 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 is just not the one end result that medical doctors and sufferers ought to take into account when evaluating the 2 medicines. He notes that Wegovy—in contrast to its competitor—is permitted by the U.S. Meals and Drug Administration to cut back the danger 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 knowledge 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 scale back the danger of coronary heart failure in some sufferers with the situation. Research are additionally exhibiting that the medicine can scale back the danger of liver and kidney signs as nicely. And Zepbound is permitted to cut back the danger of obstructive sleep apnea in folks with weight problems.
The present findings ought to assist medical doctors higher perceive which drug is perhaps 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 targets—also needs to present extra knowledge 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 out there quickly. Novo Nordisk introduced it had requested FDA approval for its oral semaglutide in Could, and Lilly expects to have outcomes from its remaining trials in just a few months; if these are optimistic, it plans to use for approval quickly after. Oral variations of those medicine might attain extra individuals who may profit from them, and the capsules may be thought of a part of upkeep remedy relying on their particular person wants. “Proper now, [those decisions] are based mostly on doctor expertise, and typically not essentially on the very best proof,” says Glass. “We are attempting to offer that proof so medical doctors and sufferers can higher make these selections.”
