Weight-loss Drugs

Weight-loss treatments have seen remarkable breakthroughs. A whole new category of drugs called glucagon-like peptide-1 (GLP-1) has emerged to reduce blood sugar level and promoting weight loss. Semaglutide (Ozempic) of Novo Nordisk was approved by the US FDA in 2017 for treatment of type 2 diabetes. It soon gained attention for off-label use in weight loss. Novo Norolisk launched Wegovy, a Semiglutide pen-injection in 2021. FDA approved it for long-term weight management.

In November 2023, Eli Lilly introduced tirzepatide (Zepbound) as a GLP-1 receptor agonist and received the FDA approval. This followed the success of tirzepatide of Lilly (Mounjaro), an injectable anti-diabetic, also used for weight loss off-label.

Zepbound and Wegovy both boost GLP-1 level in the gut and brain, making the user feel full (thereby reducing appetite). Zepbound in addition also enhances the levels of GIP (gastric inhibitory polypeptide) — another hormone the body secretes for a feeling of satiety.

In March 2024, Wegovy was approved by the FDA for reducing the risks of cardiac attacks and strokes in overweight patients. In a clinical trial, Wegovy reduced cardiovascular risk by 20 per cent. Another clinical trial proved semiglutide reduces chronic kidney disease (CKD) risk by 24 per cent. Almost 40 per cent diabetics also suffer from CKD. The European Medicine Agency (EMA) has allowed a lab update to include this benefit, and the FDA is likely to make a decision soon.

Novo Nordisk is conducting trial for CariSema, a combination of cagrilintide and semaglutide (Redefine 1) in December 2024. In a 68-week trial, the drug showed superior weight loss as compared to a placebo. The full results are expected in 2025.

Zepbound of Eli Lilly is the first prescription drug approved for adults with obesity and moderate-to-severe sleep apnea, (OSA). OSA was removed in 50 per cent participants.

Lilly conducted a trial in August 2024 of tirzepatide in heart failure patients with preserved ejection factor and obesity. Lilly expects a regulatory approval soon.

Lilly’s another trial (in June 2024) of tirzepatide was conducted for adults with MASH, a fatty lever disease that leads to inflammation. Half the patients have shown improvements.

In July 2024, an expert committee of India’s drug regulator has approved tirzepatide for chronic weight management with a kidney condition.

Lilly is expected to launch Mounjaro in India in 2025. Novo Nordisk is also expected to launch its weight-loss drugs in new year.

GLP-1 drugs will be introduced by Indian manufacturers, as these go off-the-patent. Some companies have started bioequivalence trials to prove the efficacy of these generic versions.