Ozempic and Wegovy.   The two new cash cow drugs from Novo Nordisk.  Wait- there’s yet a third one from Eli Lilly- Zepbound.

These are making money and news, despite the fact that they were developed for a specific different purpose, than the one which is making the news.  (Forexample, Ozempic is a diabetic treatment drug).

You see, it turns out, they also lead to weight loss for those who take it.  And, that loss means one’s risk from succumbing to a heart attack is diminished (by about 20%).

The factors behind this ability to augment cardiac health is unclear.  Is it due to the loss of weight?   Or some other factor that is as yet unknown. [Moreover, will this benefit prove to be universal, since right now only a select portion of patients- white folks and men (2/3 of the subjects were male have been tested) and generally on statins. Interestingly most were of the subjects were not manifesting diabetes, which is the ostensible reason to be taking the drug.]

Note that the cardiovascular benefits i mentioned manifested in patients BEFORE they began to lose weight, which would indicate that benefit is related to something else in or about the drug. The subjects were also found to have lower blood pressure, better control of their blood sugar levels, and lower inflammation rates.

The recent American Heart Association meeting was the venue where this added benefit was first discussed publicly  Not just for Wegovy, but also for Ozempic, and that new addition Zepbound (which is based upon terzepatide, a relative of semaglutide).  (All three of these pharmaceuticals contain semglutide.  Not since the introduction of stains has a drug manifested such a dramatic drop in cardiovascular risk.) 

Semagluamide affects the GLP-1 pathway.  Tirzepatide is effective within both the GLP-1 and G1P pathways, which explains why there is a higher weight loss with the latter drug.

(The clinical results were published in the New England Journal of Medicine, “Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes”.  The authors were Drs. AM Lincoff (Cleveland Clinic) with the SELECT team of 17 researchers.)

And, this study’s results have enticed Novo Nordisk to file new paperwork with the FDA (Food and Drug Administration) and the European Union to modify the label usage.  To indicate the tremendous benefits in cardiovascular disorders.  (The FDA is expected to approve the new drug indication.)

The testing of the weekly shot involved some 17000 subjects who received the direct administration of the drug or a placebo over 40 months. Those on the placebo had a heart attack rate of 8% [and died from a cardiovascular event], compared to 6.5% who were administered Wegovy.

One should  further note that a portion of those patients who received the drug dropped out of the trial.  It seems that the gastrointestinal side effects (nausea, diarrhea, and vomiting) were significant.

It is also probable that the results will require life-long administration of the drug. That is a real problem for a drug that runs some $1300 a month.

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