In a phase 3 trial spanning three years, weekly injections of tirzepatide reduced the risk of Type 2 diabetes by 94%, Eli Lilly said Aug. 20.
Tirzepatide, the active ingredient of diabetes drug Mounjaro and weight loss medication Zepbound, also led to an average weight loss of 22.9%.
About 1,030 adults who have prediabetes or are obese or overweight took the therapy for 176 weeks, and the drugmaker said its safety and tolerability profile was consistent with past research.
Mounjaro and Zepbound are glucagon-like peptide-1 receptor agonists (GLP-1) and glucose-dependent insulinotropic polypeptides (GIP).
Mounjaro and other GLP-1 medications approved for Type 2 diabetes might affect the growing prevalence of the condition — between 2012 and 2022, the overall prevalence of diabetes increased by 18.6%, a recent study found.
Here are three other updates on GLP-1s:
1. An emerging concern
Because of medication costs and side effects, some patients are breaking open their GLP-1 pens with the intent of spreading out their doses.
"There's a lot of desperation that we're seeing in our practice, and people looking for all kinds of workarounds," Laura Davisson, MD, director of medical weight management at West Virginia University Health Sciences in Morgantown, told The Atlantic.
Physicians and pharmaceutical companies advise against rationing these medicines.
2. Compounded GLP-1s
So far in 2024, U.S. poison control centers have answered 159 calls involving compounded GLP-1 medications. In 2023, there were 23, according to The New York Times. In July, the FDA issued a warning about overdosing on these medicines, reporting some hospitalizations after patients self-measured doses and healthcare providers miscalculated doses.
Despite the potential risks, the market for compounded formulations continues to grow — and some physicians are becoming more comfortable with them.
Sesame, a healthcare marketplace company backed by General Catalyst and a Costco partner, now offers a weight loss program for $249 a month.
The service includes an initial video consult, lab work and follow-up appointments as needed, and four semaglutide injections per month. Ozempic and Wegovy, the brand names for semaglutide, can cost up to $1,300 per four-week supply.
Hims & Hers Health also sells compounded semaglutide. In a recent regulatory filing, the telehealth medication company disclosed its acquisition of a 503B compounding outsourcing facility in July.
WeightWatchers is weighing the possibility of selling compounded GLP-1 medications, according to a Bloomberg report. The company is also planning layoffs of an undisclosed number of employees, including 40% of its leadership.
3. Adherence
Doug Langa, executive vice president of North America operations and president of Novo Nordisk, said the average duration of Wegovy use is about six months. In an Aug. 7 earnings call, Mr. Langa said this low adherence is due to supply constraints.
Research from Truveta, an EHR analytics company, highlighted more factors playing into discontinuation. In a study of 96,544 patients who initiated GLP-1 use, 46% of patients with Type 2 diabetes and 65% without Type 2 diabetes stopped within a year.
The opposite trend is appearing in cardiology, according Jeffrey Wessler, MD, a cardiologist with New Hyde Park, N.Y.-based Northwell Health.
"People want to take it," Dr. Wessler told Becker's. "It is really transforming how I think about managing an early stage cardiometabolic patient."
Truveta analysts found that discontinuation was tied to higher weight loss, high income and an absence of gastrointestinal adverse events. Access barriers also played a role, and there are large economic and racial disparities with respect to those receiving these medications, according to The Washington Post.