Dr. Timothy Graham, our Clinical Director at DETS, has been attending the Annual American Diabetes Association Conference. One of the many exciting presentations was learning about groundbreaking results from studies of three weight loss drugs from Lilly, a pharmaceutical company: Tirzepatide (Mounjaro), Orforglipron, and Retatrutide.
Tirzepatide (Mounjaro) was FDA approved last year as a Type 2 Diabetes medication. The other two are in clinical trials and some of the results have been revealed during this conference.
These medications offer hope for those struggling with obesity, especially individuals with type 2 diabetes who often find it challenging to lose weight.
About GLP-1 Medications
Originally developed as treatments for type 2 diabetes, GLP-1-based drugs were found to have the added benefit of significant weight loss. Recognizing this potential, pharmaceutical companies like Lilly and Novo Nordisk have quickly redirected efforts towards studying and seeking approval for different doses of these medications as weight loss treatments. GLP-1 receptors are present in cells throughout the body, including the gut and brain. By slowing down stomach emptying and regulating appetite, GLP-1-based drugs can promote feelings of fullness and help with weight loss.
Tirzepatide, an injectable drug, targets two obesity-related hormones: glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). Mounjaro (Tirzepatide) received FDA approval to treat type 2 diabetes in May 2022.
Lilly subsequently conducted additional trials to explore its potential as a weight loss treatment.
Last Year’s Announcement (2022)
At last year’s American Diabetes Association meeting, Lilly presented data demonstrating that Mounjaro could lead to a weight reduction of up to 22%.
Impressed by these results, the company requested FDA approval for Mounjaro as an obesity therapy in 2022, with a decision expected by the end of this year.
This Year’s Announcement (2023)
This year’s meeting featured Tirzepatide presentation of results from a study that specifically focused on weight loss among individuals with type 2 diabetes. This population faces greater challenges in losing weight compared to those without diabetes.
The study showed that Mounjaro could contribute to a remarkable 15.7% weight reduction in patients with diabetes. Roughly 80% on tirzepatide lost more than 5% of their body weight.
This level of weight loss has not yet been seen in this population for any obesity treatment, making the findings particularly significant.
The trial also showed several other exciting findings
- Almost half of the participants taking the tirzepatide were able to lower their A1C to normal levels
- Fasting blood sugars decreased by an average of 50 mg/dL
- Triglyceride levels decreased by more than 27%
- Fasting insulin decreased by an average of about 4mlU/L
Promising and Potentially More Economical Drugs Coming
While Mounjaro has demonstrated effectiveness, its requirement for weekly self-injections may not be practical for all patients. Injectable drugs are generally more expensive and require sterile dispensing devices.
In response, Lilly and other pharmaceutical companies are exploring oral formulations, such as orforglipron, for these powerful weight loss drugs. Currently, only two drugs in this class, semaglutide (Wegovy) and liraglutide (Saxenda), both produced by Novo Nordisk, are approved to treat obesity. However, both are injectable drugs. (See our Blog posted on 5/31/23 called Oral Semaglutide coming down the pipeline for weight loss – which talks about Novo Nordisk’s race for an oral weight loss GLP-1 medication.)
Orforglipron, An Oral Medication – Looks Impressive
Lilly presented data from a trial involving more than 270 people. In phase 2, randomized, double-blind trial, they enrolled obese adults with a body mass index (BMI) of 30 or greater, or a BMI of 27 or greater with additional risk factors associated with being overweight, and without diabetes.
The participants were randomly assigned to take an orforglipron tablet in one of four different doses once a day for nine months or a placebo. Orforglipron specifically targets GLP-1 but is being tested as a tablet, making it more convenient for patients.
The study found that those taking orforglipron lost between 9% and 14% of their initial body weight, compared to only 2% in the placebo group. These weight loss results were similar to those achieved by people taking Saxenda and Wegovy.
Click here to see the preview article in New England Journal of Medicine (NEJM)
HOT OFF THE PRESS – Retatrutide is Almost Mind-Blowing in Early Results
This announcement came in literally as I am writing this blog today…
Retatrutide, another injectable therapy, is showing astounding early results! Retatrutide could be using the trifecta in hormone receptors. GLP-1, GIP, and glucagon.
GIP is thought to improve how the body breaks down sugar; glucagon may reduce appetite and help metabolism run more efficiently.
This study is focused specifically on weight in non-diabetics (another study is looking at Type 2 diabetic patients). GIP is thought to improve how the body breaks down sugar; glucagon may reduce appetite and help metabolism run more efficiently.
The results in the phase 2 clinical trial show on average, patients lost 58 pounds (approximately 24% of their body weight) by 48 weeks into the trial.
Furthermore, a plateau had NOT been reached, meaning if the patients had remained on the medication, they could have potentially lost even more weight.
To see more information about the summary article in NEJM.
To learn more about managing diabetes, starting a weight loss program utilizing one of the medications mentioned in this article and/or are interested in clinical trials, give our office a call. We help you in your wellness journey, not illness and look forward to working with you.