2023-08-10 01:15:05
A new study on an obesity drug is causing a stir in the medical community: in addition to weight loss, Wegovy reduces the risk of heart attack, stroke and related death by 20% over five years to the heart in overweight or obese patients with cardiovascular disease.
The pharmaceutical company Novo Nordisk, which markets Wegovy, announced this result in a press release on Tuesday. Its double-blind trial was conducted among 17,604 non-diabetic adults aged 45 and older, who have a body mass index of 27 or greater, and who have documented cardiovascular disease.
The details of the study were not disclosed: they will be presented at an international scientific symposium this fall, says the manufacturer.
“This is very big news,” said the Dre Marie-Philippe Morin, specialist in bariatric surgery who practices at the University Institute of Cardiology and Pneumology of Quebec. “No drug for obesity has ever demonstrated this protective effect once morest cardiovascular disease in patients without diabetes. »
These results “strike the imagination”, according to the Dr Philippe L.-L’Allier, director of prevention at the Montreal Heart Institute. “It confirms the fact that obesity can be — and, perhaps, should be — considered a risk factor in itself, as much as the ‘classic’ risk factors, such as high blood pressure, smoking, etc. “, he says.
Approved by Health Canada, Wegovy is still not on the market in Canada. Its commercialization has been delayed due to the high demand for it in the United States. The drug, which is given by injection, is made up of semaglutide (2.4 mg), the same active ingredient found in Ozempic (1 mg), a treatment for type 2 diabetes in adults, but also used “off label” by doctors to treat obesity.
Thirst for details
Jean-Pierre Després, scientific director of the VITAM sustainable health research center, welcomes this scientific breakthrough. The press release issued by Novo Nordisk, however, leaves him unsatisfied. “I have a lot of questions — not criticisms, but questions — regarding this clinical trial: what type of patients with cardiovascular disease were included? What is the proportion of men and women? Are we going to have data on waist circumference? »
Thirty years ago, the Université Laval professor was among the first in the world to make the link between a high waist circumference (visceral obesity) and the risk of cardiovascular disease. This data seems essential to him.
“This fat in the abdominal cavity is a fat that is dangerous when you have it in excess because it doesn’t just release fat into the blood, it also releases inflammatory substances, inflammatory molecules that go “ set the cabin on fire,” explains Jean-Pierre Després. “Men with hard bellies, who look six or seven months pregnant, they’re chronically inflamed. It makes their arteries very vulnerable to heart attack and premature atherosclerosis. »
The details of the study will shed light on which types of patients would benefit the most from this drug, he believes. “We know that this type of molecule is not cheap. Now, the challenge is going to be to give the right molecule to the right patient so that we don’t end up with people who want to take this to look like Hollywood actors and actresses and look good in their bathing suit,” says Jean-Pierre Després.
Necessary thoughts
The Dre Morin believes that this new study will serve as an additional “argument” to convince the Quebec government to include drugs that specifically treat obesity in the general drug insurance plan. The Régie de l’assurance maladie du Québec does not reimburse them, and Canadian insurers have recently chosen to end reimbursement for Ozempic when used for obesity. This gives rise, she argues, to “human tragedies”.
According to the Dr Philippe L.-L’Allier, these drugs are not “an end in themselves”. They must be accompanied by a healthy diet and physical exercise, he says.
The hemodynamic cardiologist believes that a “global” reflection is needed regarding our “extremely obesogenic” society. “It’s hard to imagine allowing ultra-sweet drinks and ultra-processed foods that are untaxed — or very lightly taxed — and pay at the same time for an extremely expensive drug intended for weight loss,” he thinks.
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