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Injectable Incretins Seem Effective in Obtaining Meaningful Weight Loss in the Obese

Bloomberg Businessweek June 6th 2022 |Biotech and Pharma|Street Notes| “New Obesity Drugs From Lilly and Novo Nordisk Generate Excitement” “Dramatic levels of weight loss are being attained in clinical trials of drugs originally developed for diabetes” By Bill Alpert


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From Boer and Holst MDPI.COM A) shows healthy endocrine pancreatic function and B) shows defects in endocrine pancreatic function with the development of type 2 diabetes resulting in high blood glucose levels. Persistently high glucose levels modify cellular molecules and are directly responsible for the wide-range of pathological changes that develop in long-standing diabetes.



From Boer and Holts MDPI.COM Figure shows that incretins, GLP-1 receptor agonists, have the effect of decreasing appetite, food intake and with weight loss insulin sensitivity increases, cells making insulin function more effectively, and that glucagon, a hormone that counteracts the glucose-lowering effect of insulin, is deceased and that gastric emptying is diminished. Circulating markets of glucose metabolism improve accordingly-HbA1C, Fasting Glucose and after-meal glucose levels decline.


News out of the American Diabetes Association meeting and The New England Journal of Medicine (NEJM) on a drug group called incretins is generating excitement. Lilly notes that a Phase 3 study published in the NEJM demonstrated that “patients on the highest dose of …tirzepatide… [Lilly] lost an average of 52 pounds, or 21% of their body weight, over 18 months.”


Novo also commented that they are hoping for “even better results with…CagriSema…[Novo]. Richard Vosser (JP Morgan) upgraded Novo's stock and predicted that “Novo and Lilly will divvy up a market for incretin [-based] treatments for obesity that reaches $34 billion by 2031.” Share prices of both companies rose from Monday’s news.


To this point in time, however, drugs haven’t been effective in combating obesity. As is widely known, obesity is an important risk factor for developing “diabetes (type 2), heart disease, and other serious illnesses.” Effective pharmaceutical treatments are highly sought after because forty percent of Americans are now classified as obese and minority groups are “impacted disproportionately."


Novo’s Wegovy, “first to market…in June 2021,” is an injectable incretin that “boosts…GLP-1” and has enabled patients to “lose about 15% of their body weight.”


“Lilly’s injectable, yet to be approved by the FDA, “boosts two hormones” and reportedly was more effective than Wegovy “in the Lilly trial.” These patients “lost more fat than muscle” thereby increasing their lean body mass, reducing their waist circumference, blood pressure and serum cholesterol. Appetites eased and [the patients] ate less.”


Novo commented that its drug CagriSema also boosts multiple hormones and, in an early or Phase 1 study, the drug resulted in “an average of 17%” loss in patient weight. Voss speculated that ultimately CagriSema may outperform the Lilly drug with “24% average weight loss” compared to 21% average weight loss for Lilly’s tirzepatide.


Lilly and Novo have other weight loss drugs in their developmental pipeline and the author, Bill Alpert, ends with the note that “Patients and doctors are likely to have many options by the end of this decade.”



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