2024-02-21 07:48:37
A new anti-obesity drug reduces heart health problems
The drug semaglutide, which is popular for dramatic weight loss, may also prevent heart attacks, strokes and deaths in people with heart disease. This discovery, published in the New England Journal of Medicine in the fall of 2023, shows for the first time that treating obesity helps people live longer and reduces cardiovascular problems.
Semaglutide was developed as a drug to treat type 2 diabetes and was first marketed as Ozempic. In addition to improving blood sugar control, the drug also helped people lose significant amounts of weight. After studies confirmed this benefit, the US Food and Drug Administration approved a higher-dose version of semaglutide (sold as Wegovy) for people who are overweight or obese.
Evidence of the drug’s benefits to the heart
The aforementioned New England Journal of Medicine study compared a 2.4 milligram dose of semaglutide (the higher dose from Wegovy) with a placebo. It was conducted on more than 17,000 people with cardiovascular disease. All of them were overweight or obese, but none of them suffered from heart disease. Diabetes. Over an average follow-up period of 3.3 years, people who took semaglutide were 20 percent less likely to have a heart attack, stroke, or die from heart disease than those who took a placebo.
“The results highlight the fact that obesity is a risk factor for cardiovascular disease,” says Dr. Benjamin Sirica, a cardiologist at Brigham and Women’s Hospital, Harvard University. People who took semaglutide lost approximately 19 pounds (regarding 453 grams) on average, which likely explains why their blood pressure, triglycerides, LDL cholesterol, and inflammation improved. However, Sirika added that other factors might also be among the reasons.
Hormone simulation
Semaglutide belongs to a class of medications called glucagon-like peptide-1 (GLP-1) agonists (GLP-1s), which mimic hormones naturally made by the gut and brain. These medications stimulate the pancreas to secrete insulin, which in turn helps control blood sugar. They also slow down the rate of stomach emptying and reduce appetite, which reduces the amount of food a person eats. GLP-1 receptors are also found in the heart, kidneys, and blood vessels, which means that some heart-related benefits may not be associated with weight loss, according to Dr. Sirica.
It collects another related drug; Tirzepatide, between GLP-1 and GIP, is a hormone that is thought to enhance the effects of GLP-1. Trizipatide is sold under the name Mounjaro to treat diabetes, and under the name Zepbound for weight loss. It appears to promote weight loss more than semaglutide. A clinical trial is currently underway to test trizipatide in obese people who have a high risk of heart disease.
Who is a candidate to take these drugs?
Anyone with type 2 diabetes is a suitable candidate for either Ozempic or Mounjaro. “Many patients have good results with these medications, and they are usually covered by health insurance,” Dr. Sirica says. However, only regarding 30 percent of people with heart disease have diabetes, while this percentage rises to more than 50 percent for people with heart disease who are overweight or obese.
The drugs Wegovy and Zepbound have been approved by the US Food and Drug Administration for weight loss in people who meet the definition of obesity (BMI of 30 or more), and who also fall into the upper category of overweight (BMI). From 27 to 29.9), and they have a health problem associated with being overweight, such as high blood pressure or high cholesterol.
However, the high demand for these medications has caused a shortage in supply, and they are also expensive, ranging in cost from $900 to $1,600 per month. The American insurance program, Medicare, does not cover any weight loss medications, although some private insurance companies do.
However, given the intense interest and enthusiasm for these drugs, experts believe that recommendations for their use will change in the coming years. What can you do then? Dr. Sirica offers the following advice: “Call your insurance company to find out your options based on your current health condition, then talk to your doctor.”
A frustrating history of diet medications
For decades, pharmaceutical companies have struggled to develop an effective and safe drug to aid weight loss. In this regard, Dr. Benjamin Sirica, an associate professor at Harvard Medical School, says: “Many drugs that were initially promising did not succeed in passing the development stage, and other drugs were withdrawn from the market.”
The most famous example dates back to a year ago, when a combination of fenfluramine and phentermine (known as Fen-Phen) was withdrawn from pharmacy shelves following people who took it developed severe heart valve disease and pulmonary hypertension. In 2010, sibutramine (Meridia) was also withdrawn from the market, following studies linked its consumption to an increased risk of heart attacks and strokes.
* Harvard Heart Letter, Tribune Media Services.
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