The subsequent wave of weight problems medicine is coming quickly.Drug corporations are racing to develop GLP-1 medicine following the blockbuster success of Novo Nordisk’s Ozempic and Wegovy and Eli Lilly’s Mounjaro and Zepbound.Among the experimental medicine might transcend diabetes and weight reduction, bettering liver and coronary heart perform whereas lowering unwanted side effects similar to muscle loss frequent to the prevailing drugs. On the 2024 American Diabetes Affiliation convention in Orlando, Florida, researchers are anticipated to current knowledge on 27 GLP-1 medicine in growth.“We’ve heard about Ozempic and Mounjaro and so forth, however now we’re seeing tons and many totally different drug candidates within the pipeline, from very early-stage preclinical all over late-stage medical,” mentioned Dr. Marlon Pragnell, ADA’s vp of analysis and science. “It’s very thrilling to see a lot proper now.”A big portion of the info offered comes from animal research or early-stage human trials. Nonetheless, some displays embrace mid-to late-stage trials, in response to a listing shared by the group.Approval by the Meals and Drug Administration is probably going years away for many. Among the medicine showcased could possibly be accessible for prescription within the U.S. inside the subsequent few years.“We’ve witnessed an unprecedented acceleration within the growth of GLP medicine,” mentioned Dr. Christopher McGowan, a gastroenterologist who runs a weight reduction clinic in Cary, North Carolina. “We at the moment are firmly entrenched within the period of the GLP.”Whereas the prevailing medicine are extremely efficient, new medicine which are extra inexpensive and have fewer unwanted side effects are wanted, McGowan added.There aren’t simply GLP-1 medicine within the pipeline. On Thursday, forward of the diabetes convention, Denmark-based biotech agency Zealand Pharma launched knowledge that confirmed a excessive dose of its experimental weight reduction drug petrelintide helped cut back physique weight by a median of 8.6% at 16 weeks.The weekly injectable remedy is exclusive as a result of it mimics the hormone amylin, which helps management blood sugar. The hope is sufferers will expertise fewer unwanted side effects like nausea generally related to GLP-1 medicine similar to Wegovy and Zepbound.Can glucagon hormone assist with weight reduction? GLP-1 drugs work, partly, by slowing down how rapidly meals passes via the abdomen, main folks to really feel fuller longer. In a number of of the upcoming weight reduction medicine, a special hormone known as glucagon is within the highlight. Glucagon is a key blood-sugar-regulating hormone that may mimic the results of train.One of many medicine featured on the convention on Sunday known as pemvidutide, from Maryland-based biotech agency Altimmune.The drug accommodates the GLP-1 hormone, a key ingredient in Ozempic and Wegovy, along with glucagon.Altimmune launched knowledge from a section 2 trial of 391 adults with weight problems or who’re chubby with at the very least one weight-related comorbidity similar to hypertension. Sufferers have been randomized to both get considered one of three doses of pemvidutide or a placebo for 48 weeks.Researchers discovered that sufferers who bought the best dose of the drug misplaced on common 15.6% of their physique weight after 48 weeks, in comparison with the two.2% physique weight reduction seen in sufferers who bought a placebo. In comparable trials, semaglutide was proven to scale back physique weight by round 15% after 68 weeks.These should not direct comparisons as a result of the medicine weren’t in contrast in a head-to-head medical trial.Dr. Scott Harris, Altimmune’s chief medical officer, mentioned the drug has been proven to assist folks drop some weight, in addition to present well being advantages to the liver and coronary heart. What’s extra, the drug has proven advantages in preserving lean physique mass. Some research have instructed that semaglutide, the energetic ingredient in Ozempic and Wegovy, could cause muscle loss.“If folks take the medicine long run, what’s going to be their long-term well being? What’s going to be the long-term results on their physique composition, their muscle, their capacity to perform?” he mentioned.Harris mentioned that individuals who bought pemvidutide misplaced on common 21% of their lean physique mass, which is decrease than the round 25% of lean physique mass folks usually lose with food regimen and train.“We’re the subsequent wave of weight problems medicine,” Altimmune President and CEO Vipin Garg mentioned. “The primary wave of mechanisms was all pushed by urge for food suppression. We’re including one other element.”Altimmune expects to start a section 3 trial quickly. The corporate hopes the drug will likely be accessible within the U.S. someday in 2028.Competitors might drive down costsExpanding the variety of weight reduction medicine accessible is necessary for a number of causes, specialists say.Extra choices might additionally assist alleviate the shortages seen within the U.S. with Novo Nordisk’s and Lilly’s weight reduction medicine.Newest information on weight reduction medicationsIncreased competitors might drive down the excessive value of the medicine over time. A month’s provide of Wegovy or Zepbound can value greater than $1,000, usually financially untenable for a lot of sufferers, specialists say.Sufferers may also reply otherwise to therapies, mentioned Dr. Fatima Cody Stanford, an affiliate professor of medication and pediatrics at Harvard Medical College. In reality, some have discovered the prevailing GLP-1 choices ineffective.“Completely different GLP-1 medicine might have various ranges of efficacy and efficiency,” she mentioned. “Some sufferers might reply higher to at least one drug over one other, relying on how their physique metabolizes and responds to the remedy.”Since beginning Ozempic in June 2022, Danielle Griffin has not seen the outcomes her physician predicted. “She actually anticipated to see an enormous distinction in my weight, and I simply by no means noticed it,” mentioned the 38-year-old from Elida, New Mexico. Griffin weighed about 300 kilos and has misplaced solely about 10 pound in two years. She mentioned her “expectations have been just about shattered from that.”RecommendedAmid insurance coverage battles and shortages, she has additionally tried Wegovy and Mounjaro, however didn’t see a distinction in her weight.“I don’t really feel like there are alternatives, particularly for myself, for somebody who the drugs not working for.”The prospect of recent drugs on the horizon excites Griffin. “I might be prepared to attempt it,” she mentioned, including that “it could possibly be life altering, truthfully, and you already know that alone offers me one thing to sit up for.”Extra medicine within the pipelineEli Lilly, which makes Zepbound and the diabetes model Mounjaro, has two extra GLP-1 medicine in growth.On Sunday, Lilly launched new knowledge about retatrutide, an injectable drug that mixes GLP-1 and glucagon, plus one other hormone known as GIP. GIP is believed to enhance how the physique breaks down sugar.In an earlier trial, retatrutide helped folks lose, on common, about 24% of their physique weight, the equal of about 58 kilos — better weight reduction than another drug available on the market.New findings confirmed the weekly remedy additionally considerably decreased blood sugar ranges in folks with Sort 2 diabetes.On Saturday, there have been additionally new findings on the experimental mazdutide, which Lilly is growing in partnership with the Chinese language biotech agency Innovent Biologics. The drug combines GLP-1 and glucagon.In a section 3 examine of adults in China who have been chubby or had weight problems, researchers discovered that after 48 weeks, a 6-milligram dose of the drug led to a median physique weight discount of 14.4%.The drug additionally led to a discount in serum uric acid — a chemical that may construct up within the bloodstream, inflicting well being issues, and has been related to weight problems, in response to Dr. Linong Ji, director of the Peking College Diabetes Middle, who offered the findings.That was “fairly distinctive and by no means reported for different GLP-1-based therapies,” he mentioned in an interview.The drug could possibly be accredited in China in 2025, Ji mentioned.Bettering metabolic conditionsAn estimated 75% of individuals with weight problems have nonalcoholic fatty liver illness and 34% have MASH, or metabolic dysfunction-associated steatohepatitis, in response to researchers with the German drugmaker Boehringer Ingelheim. Fatty liver illness happens when the physique begins to retailer fats within the liver. It may possibly progress to MASH, when fats buildup causes irritation and scarring.In a section 2 trial of people that have been chubby or had weight problems, Boehringer Ingelheim’s survodutide, which makes use of each GLP-1 and glucagon, led to weight lack of 19% at 46 weeks. One other section 2 examine in folks with MASH and fibrosis discovered that 83% of individuals additionally confirmed enchancment in MASH.Survodutide “has vital potential to make a significant distinction to folks dwelling with cardiovascular, renal and metabolic circumstances,” mentioned Dr. Waheed Jamal, Boehringer Ingelheim’s company vp and head of cardiometabolic medication.On Friday, the corporate launched two research on the drug. One, in hamsters, discovered that weight reduction was related to enhancements in insulin and ldl cholesterol. The second, in folks with Sort 2 diabetes or folks with weight problems, discovered the drug helped enhance blood sugar ranges. The corporate is seeking to start a section 3 trial.Berkeley Lovelace Jr. is a well being and medical reporter for NBC Information. He covers the Meals and Drug Administration, with a particular give attention to Covid vaccines, prescription drug pricing and well being care. He beforehand coated the biotech and pharmaceutical business with CNBC.Marina Kopf contributed.