As extra docs and sufferers flip to the most recent weight-loss medicine, 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 medicine are and which unwanted side effects individuals may expertise whereas taking them.
A brand new research revealed within the New England Journal of Drugs and introduced 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 had been launched in Dec. by Eli Lilly, who funded the research. The present report contains extra particulars on how the 2 medicine affected waist circumference and different measures, in addition to their unwanted side 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 yr 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 unwanted side effects, primarily regarding gastrointestinal signs together with nausea, constipation, diarrhea, and vomiting. Nonetheless, these taking Zepbound reported extra injection-site reactions than individuals getting Wegovy. These tended to turn out to be much less frequent with extra weekly injections.
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“The concept right here is that we didn’t have choices earlier than—or we had very unhealthy choices—and now we now have higher and higher therapies, and they’re completely different,” says Dr. Leonard Glass, senior vp of worldwide 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 medicine must 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 properly, 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 shouldn’t be the one end result that docs and sufferers ought to think about when evaluating the 2 medicines. He notes that Wegovy—not like its competitor—is authorized by the U.S. Meals and Drug Administration to scale back the chance of coronary heart assault, stroke, and coronary heart illness in individuals with a historical past of coronary heart issues who’re obese or overweight. “Once 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 cut back the chance of coronary heart failure in some sufferers with the situation. Research are additionally displaying that the medicine can cut back the chance of liver and kidney signs as properly. And Zepbound is authorized to scale back the chance of obstructive sleep apnea in individuals with weight problems.
The present findings ought to assist docs higher perceive which drug could be proper for which affected person. Extra research that each firms are conducting—together with these following individuals as soon as they’ve reached their weight-loss targets—must also present extra knowledge on how these medicine may assist individuals keep a wholesome weight. Each Lilly and Novo Nordisk additionally plan to have oral variations of their injectable medicine accessible quickly. Novo Nordisk introduced it had requested FDA approval for its oral semaglutide in Might, and Lilly expects to have outcomes from its last trials in a number of months; if these are constructive, it plans to use for approval quickly after. Oral variations of those medicine may attain extra individuals who may profit from them, and the capsules is also thought-about a part of upkeep remedy relying on their particular person wants. “Proper now, [those decisions] are based mostly on doctor expertise, and generally not essentially on one of the best proof,” says Glass. “We are attempting to offer that proof so docs and sufferers can higher make these choices.”
