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Jared Holtz considered taking one of the new GLP-1 drugs to lose weight for months before filling his prescription. And even when he took the medicine, he waited a month before using it.
Part of his hesitation: he doesn't like injections and all the drugs in this class are shots that users who are approved for weight loss give themselves once a week.
“It was really challenging,” said Holmes, 44, about a week into treatment.
But the need for needles may change soon. At least 12 similar experimental weight-loss drugs designed to be taken as pills are working in clinical trials, with the most advanced now in the third and final phase of testing.
“They will dramatically change the landscape of weight management in many ways,” he said Dr. Jody Dushay, An assistant professor of medicine at Harvard Medical School and an attending physician in endocrinology at Beth Israel Deacon Medical Center, he prescribes weight-loss drugs.
It is already a revolution in the field. Millions People all over the US now use semaglutide and tirzepatide, sold as Wegovy and Zepbound for weight loss (and sold as Ozympic and Mounjaro for diabetes).
Dushay expressed hope that pill versions of GLP-1 drugs could be made easier Shortcomingscome at a lower cost and improve comfort. But she and other doctors also warned of the potential for abuse, this problem may be more widespread with a daily pill than a weekly injection; They make it easy to take more than recommended or misuse medications.
“We have a lot to learn about the oral version,” Dushai said.
The most advanced of these pills include a form of Semaglutide, the active ingredient in Ozempic and Wegovy, developed by Novo Nordisk. Danish drug maker reported Last year, a late-stage study of non-diabetic people showed that the daily pill led to an average weight loss of 15% over 68 weeks, similar results to those seen in the Wegovy trials.
But Novo Nordisk declined to say whether it had filed for approval of the drug from the US Food and Drug Administration. Sales Oral semaglutide, approved as Rybelsus for type 2 diabetes, has been weakened by osempic injections.
Even though it is a pill, Rybelsus comes with some complications: it should be. picked up Every day on an empty stomach, without eating, drinking or taking any other drugs for at least 30 minutes, and doctors say that the injection may not be as effective as an injection, but it still has side effects.
And the dosage of oral semaglutide for obesity is much higher, which comes with the potential for more pronounced side effects, he said. Dr. Jorge Morenoobesity specialist and assistant professor of medicine at Yale School of Medicine. The dosage for weight loss is 25 to 50 milligrams per day, 14 milligrams for Rybelsus and a maximum of 2.4 milligrams per week for Wegovy injection.
“I saw something more important [gastrointestinal] Moreno said oral semaglutide has more side effects than injectables. [the] “Injectable amount”.
In the trial, Novo Nordisk said “most” side effects of oral semaglutide were “mild to moderate and decreasing over time.” All GLP-1 Medicines Although not all patients are associated with side effects including nausea, vomiting and stomach pain.
Hot on the heels of oral semaglutide is Eli Lilly's Orforglipron, an oral drug that also targets GLP-1, a hormone involved in insulin regulation, appetite and digestion.
Lily, who also has Zipbod and Munjaro; reported In a mid-stage trial last year, people taking orforglipron for 36 weeks lost an average of 15% of their body weight — a similar amount in less time than oral semaglutide. Evan Seigerman, a research analyst at financial firm BMO Capital Markets, said the results of the latter phase of the study are expected in the first half of next year.
Drug makers, including Pfizer and Roche, as well as smaller companies Structure therapeutics, Terns Pharmaceuticals And Viking TherapeuticsThey also have oral weight loss drugs in the early stages of development, according to BMO research.
And Novo Nordisk does not stop with semaglutide; It has several programs in the early stages of development to bring the next generation of weight loss pills to market.
At the beginning of this month Data A study presented in the European Association for the Study of Diabetes found that study participants who took high doses of the experimental drug amicretin lost an average of 13% of their body weight over 12 weeks. The medicine Targets Both GLP-1 and another hormone, amylin.
Novo Nordisk as well agreed Last year, Inversago spent up to $1.1 billion to acquire Pharma, an experimental oral drug called monlunabant. Cannabinoids An important receptor for appetite control. The results of a mid-stage study on this drug are expected this year, according to BMO Research.
“Maintenance Rate”
Not all of these experimental drugs are necessarily marketed, but if they are, one of the main roles they play is as a “long-term maintenance dose” for people who have lost enough weight on injectable drugs, Dushay said.
The drugs can provide an excellent alternative to weekly injections, Dushay said. “They may not be effective as an initial treatment for weight loss, but they can be excellent for weight loss maintenance, which is a very important destination for specific and lasting health benefits.”
According to a recent post, Eli Lilly will test that Study plans Federal database of clinical trials. The company plans to try orforglipron to repair weight loss in people who participated in another study ExperimentComparing the drug Zepbound with Novo Nordisk's Wegovy. The weight maintenance trial began this month and is expected to be completed by early 2026.
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Holtz, who follows the weight-loss drug competition closely in his role as a health care strategist for an investment firm, said he hopes to keep the now-weekly injection-to-oral option, if one becomes available. His weight loss.
Within three months, he had gained more than 10 percent of his body weight, and said he was eager not only for weight loss, but for GLP-1 drugs. heart and other possible health Benefits.
The weekly injection he was concerned about turned out to be painless — something drugmakers have worked to achieve with autoinjector pens — and, he reflects, he wishes he had started sooner.