Demand for drugs such as Ozempic and Wegoby has skyrocketed thanks to their weight-loss benefits, and drug companies are now developing new tablet versions that could make them even more popular.
Currently, these drugs must be injected into the thigh, lower back, or upper arm once a week. Tablets and pills may be easier and more convenient to take for many patients. “Another route of administration would be of great benefit,” says Michael Weintraub, an endocrinologist and assistant clinical professor of medicine at New York University Langone Health. Many people have a fear of needles and may not want to be seen injecting drugs.
Last week, Novo Nordisk, which manufactures semaglutide under the Ozempic and Wegovy brand names, Announces positive clinical trial results For drugs in tablet form. In a trial of 667 overweight or obese adults, participants who took daily tablets lost an average of 15.1 percent weight over 17 months, compared to 2.4 percent for those who took placebo tablets. percent decreased. The results were comparable to previous trials of weekly injections of Wegovy. almost 15 percent Change in body weight over the same period.
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Martin Horst Lange, Executive Vice President of Development at Novo Nordisk, said: “The choice between daily pills or weekly injections for obesity offers patients and healthcare providers the best fit for their individual treatment preferences. It could give us the opportunity to choose things,” he said. company statement. The company plans to seek approval for the tablet in the US and Europe later this year.
Semaglutide was originally developed to treat type 2 diabetes. It mimics a hormone called GLP-1 that regulates insulin. However, scientists have found that it also leads to weight loss in both laboratory animals and humans. This is because GLP-1 sends a signal to the brain when it’s full, causing people taking these drugs to eat less and have less appetite. Ozempic is now approved in the United States and other countries to treat her type 2 diabetes, and Wegobee is specifically indicated for chronic weight management.
Novo Nordisk already makes a tablet version of semaglutide, but it hasn’t shown as much weight loss as Ozempic or Wegobee.it was called Libersus Approved in 2019 A treatment for type 2 diabetes by the U.S. Food and Drug Administration. This pill is only 14 milligrams, while the one the company is currently testing is he’s 50 milligrams.
In the current study, researchers found that the new tablets were safe, but had gastrointestinal side effects in some patients. Most of them are mild to moderate and will lessen over time, the company said in a statement. The statement said side effects were similar to those experienced by patients with Ozempic and Wegoby. These drugs can cause nausea, vomiting, bloating, constipation, and diarrhea. Often these occur in the early stages of taking the drug, when the dose is steadily increased, but decreases after a few weeks.
“People can become very dehydrated when taking these drugs, because not only do they forget to eat, they also forget to drink,” says endocrinologist at Rutgers University, an obesity treatment specialist. Kunal Shah, Assistant Professor of Science, said, referring to Ozempic and Wegovy. .
Shah said these side effects could become more frequent or severe with higher doses of the new tablets. “That’s more than three times the amount we normally give oral semaglutide,” he says of the experimental tablet dosage. And since the current study compares high-dose pills to placebo, it’s not clear how the new pill’s side effect profile overlaps with the injectable.
Novo Nordisk spokeswoman Alison Scheider declined to provide details about the side effect risks, saying those details would be announced at the American Diabetes Association meeting later in June.
Pfizer is also working on a weight-loss drug.Last week the company Publish positive results The experimental drug danugliprone is another molecule that mimics the GLP-1 hormone.
A trial of various doses of the pill in 411 adults with type 2 diabetes found that participants who took the higher dose lost an average of about 10 pounds over four months compared to those who took a placebo. I lost weight. The most common side effects were nausea, diarrhea, and vomiting. Fifty-seven participants were discontinued due to these side effects, although most were mild in nature. As with other GLP-1 drugs, these side effects were more common early in the course of treatment and diminished over time, Pfizer spokeswoman Jerika Pitts told WIRED in an email. “With proper counseling before the first dose, patients can overcome these initial difficulties and stay on medication,” Pitts wrote.
Tablet versions of these weight loss pills may come with strict instructions on how to take them. Existing semaglutide tablets “Libersus” should be taken in the morning at least 30 minutes before meals, drinks and other oral medications and can only be taken with a small amount of water. “If you don’t adhere to these strict standards, absorption is hampered,” says Weintraub.
Pfizer’s tablets may have an advantage in this regard, Weintraub said. Because its absorption is unaffected by food, patients can take it with food. However, Pfizer’s danugliprone should be taken twice daily, in the morning and in the evening. Pfizer is developing another diabetes drug called rotigliprone, which is designed to be taken once a day. Both are in Phase II clinical trials, and Pitts said he will make a decision by the end of the year as to which one will advance to late-stage trials.
Amy Rothberg, a physician and clinical professor at the Michigan Health College who specializes in weight management and diabetes treatment, says semaglutide’s bioavailability—that is, how much of the drug reaches its destination—is a function of its formulation into a tablet. It is said that it is a problem when making it. Injecting semaglutide is a more efficient way to get semaglutide into the bloodstream, so Ozempic and Wegovy’s syringes use only a small amount of drug, she says. However, swallowing it in tablet form means that much of it has to pass through the digestive tract, where it is absorbed.
She believes most patients would prefer pills to current injections. “That said, people forget their meds all the time. Patients have to commit to taking something every day,” says Rothberg. When Ozempic and Wegobee are discontinued, appetite increases again, and many people who stop taking these drugs regain their weight.
As for the price of the new weight-loss drugs, they are likely to be as expensive as injections, at least initially, Shah said. “If a new drug or new version of a drug hits the market, it is very unlikely that insurance will apply immediately,” he says. Most insurance companies cover these drugs for diabetes, but not necessarily just for weight loss. Ozempic and we goby According to Novo Nordisk list prices, it costs about $900 and $1,300 per month without insurance.
Novo Nordisk spokesman Scheider said in an email that it was too early to speculate on the price of the tablet version. “It’s too early to comment on pricing at this point,” Pitts wrote of Pfizer’s in-development tablets.
