Ozempic and other similar drugs have proven to be powerful in regulating blood sugar levels and promoting weight loss. Scientists are now studying whether it could similarly be transformative in the treatment of a wide range of other diseases, from addiction and liver disease to common causes of infertility.
“It's like a snowball turned into an avalanche,” said Lindsey Allen, a health economist at Northwestern Medicine. As drugs gain momentum, “they leave behind this completely reshaped landscape,” she said.
Much of the research into other uses for Ozempic and Wegovy's compound semaglutide and Mounjaro and Zepbound's substance tirzepatide is only in its early stages. One of the biggest questions scientists are trying to answer is: Are the benefits of these drugs ultimately just weight loss, or do they have other benefits, such as reducing inflammation in the body or calming the brain's obsessions? , could there be other effects that would allow the treatment of far more diseases?
We probably won't know right away. “We're still learning how these drugs work,” said Dr. Daniel Drucker, one of the first researchers to study these drugs. (Dr. Drucker consults for Novo Nordisk, the company that makes Ozempic and Wegovy.)
People with the following conditions, many of whom have few appropriate treatments, could benefit in the long term if these trials are successful. And for weight-loss drug makers, each new use has the potential to catapult a drug even further into a blockbuster. Some of these applications, such as heart disease and sleep apnea, which each affect tens of millions of people, are targeted by these companies and could be particularly lucrative. These drugs are a “treasure trove,” Dr. Allen says. “There is no upper limit to where the market can go.”
As evidence emerges from these studies, researchers will gain a clearer understanding of how exactly these drugs work in the body. If we can treat more diseases, medicine could be transformed again.
alcohol use disorder
problem
Alcohol use disorder, also known as alcoholism, is common – Approximately 30 million people in the United States This will be the case in 2022.But it is Rarely are people diagnosed, and often very difficult to find a cure.Effective medications are available over the counter, but some people may benefit from them. haven't noticed That they exist.
possibility
Anecdotally, some people who take drugs like Ozempic say the drugs cause them to drink less and, in some cases, quit alcohol altogether. Researchers are trying to figure out why. Taking these drugs makes you feel full, which can cause you to lose interest not only in food but also in alcohol. Also, because these drugs target the part of the brain that regulates appetite, they can be associated with compulsive behaviors that may involve that area of the brain, such as alcohol or stimulant use, gambling, smoking, and even nail biting. may also have an impact.
early evidence
One small study They followed six people with alcohol use disorder who were taking semaglutide for weight loss. All six of them significantly reduced their drinking after taking the drug for 1 to 9 months.in online survey Among 153 obese adults, most of whom were white and female, those taking semaglutide or tirzepatide reported drinking significantly less alcohol than their peers not taking the drugs.
Although data is limited, some patients with alcohol use disorder have already started asking their doctors questions about these drugs. Researchers studying how these drugs affect drinking recently responded to that request: piece Nature Medicine urges doctors not to use drugs to treat alcohol use disorder without further research.
polycystic ovary syndrome
problem
Any amount Five million people in the United States have polycystic ovary syndrome (PCOS). This condition is a major cause of infertility and causes menstrual irregularities. There are treatments available, including changes in diet and exercise, oral contraceptives, and the diabetes drug metformin, but they do not work for everyone.
possibility
Researchers believe that high testosterone levels contribute to PCOS. When people with this condition lose weight, their testosterone levels often decrease. “Drugs like Ozempic could help regulate hormones in PCOS patients,” said Melanie Cree, Ph.D., who is leading one of the early studies investigating whether semaglutide can resolve PCOS symptoms. Stated.
early evidence
a small study A study of 27 people with obesity and PCOS who took low doses of semaglutide found that after 6 months, most participants lost weight, had more regular menstrual cycles, and their PCOS improved. It was suggested that it was under control. Dr. Cree completed a study of semaglutide in adolescent girls with PCOS, which showed similar results. She is recruiting another researcher to focus on the menstrual cycle.
liver disease
problem
to 70 percent Percentage of people with type 2 diabetes aged 50 and over 90% of people People who are obese have nonalcoholic fatty liver disease (NAFLD), which occurs when excess fat accumulates in the liver. This condition can cause liver damage so severe that some patients may eventually develop liver damage. Liver transplant.
possibility
Doctors usually advise obese or overweight patients with NAFLD to lose weight to reduce the amount of fat and inflammation in the liver. Because drugs like Ozempic help you lose weight, they may also reduce the amount of fat stored in your liver. type 2 diabetes too Increased risk NAFLD's. Treatment with drugs like Ozempic may also reduce the risk and severity of liver disease.
Scientists have two other theories about how the drug might help. One is to improve insulin resistance, which is common in her NAFLD patients, and the other is to reduce inflammation that can damage the liver.
early evidence
a Research funded by Novo Nordisk They found that compared to a placebo, semaglutide did not significantly improve liver scarring or recovery from nonalcoholic steatohepatitis (NASH, a severe form of nonalcoholic fatty liver disease). The study included people with cirrhosis, or livers that were scarred and permanently damaged.bigger Trial funded by Novo Nordisk They found that early-stage patients taking semaglutide were more likely to have their NASH resolved than those taking a placebo, but their scarring was not significantly more likely to improve.
Novo Nordisk is currently Larger clinical trials Studies are being conducted on semaglutide and NASH, and the Food and Drug Administration has designated the drug a “breakthrough treatment” for the disease, which will speed up regulatory review. Researchers funded by Eli Lilly They are also studying whether tirzepatide can treat NASH.
cardiovascular problems
problem
Heart disease killed Approximately 700,000 people will die in the United States in 2022, making it the leading cause of death in the United States. Experts say new treatments are urgently needed that can reduce the risk of heart attacks and strokes and improve symptoms such as fatigue and shortness of breath that make it difficult for people with heart disease to get through the day. ing.
possibility
Because obesity significantly increases the risk of cardiovascular disease, some doctors believe that losing weight may be able to treat and prevent heart disease. These drugs may also help reduce inflammation, which can cause plaque to form in the heart and lead to blood clots.
early evidence
A large trial conducted in November showed that semaglutide reduced the risk of heart attacks and strokes by 20 percent in obese and overweight people with heart disease. another trial A proportion of people with obesity and certain types of heart failure have found that semaglutide may improve symptoms and make exercise easier.Eli Lilly is Conducting its own clinical trials About tirzepatide and heart failure. And more research is underway. Researchers are investigating whether semaglutide is effective. reduce plaque in the heart, improve symptoms heart failure or Reduce damage from strokes.
sleep apnea
problem
Estimation 30 million People in the United States suffer from obstructive sleep apnea, a condition in which breathing repeatedly stops and restarts during sleep. Treatments such as the use of continuous positive airway pressure machines (CPAP) can be effective, but patients often find them uncomfortable. Most cases of sleep apnea go undiagnosed. If not treated properly, this condition can seriously damage people's health and increase the risk of complications such as heart disease and type 2 diabetes.
possibility
Sleep apnea syndrome is more common in obese people. This is due to a complex set of factors, including the fact that fat deposits in the neck can clog the airways when a person is lying down. Research has shown that weight loss can be achieved by: bariatric surgerycan help.
early evidence
Although there is little data so far, an Eli Lilly spokesperson said the company plans to complete its study of tirzepatide and sleep apnea in spring 2024. Novo Nordisk is currently not studying whether semaglutide can treat sleep apnea.
kidney disease
problem
almost 1 in 3 people Adults with type 2 diabetes also have chronic kidney disease, which occurs when the kidneys become damaged and cannot function properly. Patients with this disease may eventually require dialysis or a kidney transplant, and the condition can be fatal if left untreated.
possibility
Dr. George Bakris, who participated in the Novo Nordisk-supported clinical trial of semaglutide in patients with type 2 diabetes and chronic kidney disease, said kidney damage occurs slowly over time and in almost all cases. He said it was irreversible. Drugs like Ozempic may help prevent further damage, as weight loss may also reduce the risk of high blood pressure and type 2 diabetes, which are risk factors for chronic kidney disease.
It is not entirely clear how else these drugs improve chronic kidney disease, but one potential factor is that these drugs can reach levels that are harmful to people with chronic kidney disease. It has the potential to reduce inflammation.
early evidence
novo nordisk announced in october Although the company has not yet released data, it announced that it had halted a trial of semaglutide in patients with type 2 diabetes and chronic kidney disease after an initial analysis revealed semaglutide's efficacy.The company is Fund another study Find out how semaglutide works in the kidneys.Eli Lilly is Funding trial of tirzepatide in obese patients and chronic kidney disease.
These and other studies are part of what Dr. Howard Forman, a professor of medicine at Yale University who specializes in health policy, calls an “explosion of opportunity.”
It remains to be seen whether those opportunities will translate into new treatments.
“We're in a very early upswing for this whole industry, and there's nothing surprising about it,” Dr. Forman said.
