Novo’s new Drug Development Partnership; Oprah on Making the Shift; No One Knows How to Talk About Weight Loss Anymore; One in Eight Adults in US have taken a GLP-1 Drug.

AT A GLANCE

  • Reuters states Novo Nordisk ties up with Metaphore from Flagship Pioneering to develop new obesity drugs.
  • Oprah, in collaboration with Weightwatchers CEO Sima Sistani, joined by actress Rebel Wilson, as well as obesity experts this week.
  • I am encouraged to read Jamie Ducharme’s article in TIME this week titled No One Knows How to Talk About Weight Loss Anymore – spot on!
  • Betsy McKay at The Wall Street Journal on keeping weight off, after losing it on a GLP-1 drug.
  • The KFF Health Tracking Poll finds that about one in eight adults (12%) say they have ever taken a GLP-1 agonist…

NEWS

  • Reuters states Novo Nordisk ties up with Metaphore from Flagship Pioneering to develop new obesity drugs.
  • The intent is to develop two therapies for obesity, in the link up with Metaphore, founded by U.S. investment firm Flagship Pioneering – also behind Covid-19 company Moderna.
  • The article states ‘…Novo may pay up to $600 million in various milestone payments, as well as royalties on annual net sales of licensed products…’ as per Metaphore.
  • Flagship Pioneering has additional programs with the Novo Nordisk partnership, based upon two companies – Omega Therapeutics and Cellarity – announced earlier this year.

OPINION

  • Oprah, in collaboration with Weightwatchers CEO Sima Sistani, was joined by actress Rebel Wilson, as well as experts Rachel Goldman, PhD and Ania Jastreboff, MD PhD at Yale University, in an online special.
    • Oprah said the event ‘…unpacks everything we’ve internalized about diet culture and how our weight somehow reflects our worth.’
    • The streaming episode ‘Making the Shift: A New Way to Think About Weight’ is now viewable on YouTube.
  • Elaine Chen at STAT reports on MariTide, a monthly GLP-1/GIP shot developed by Amgen, with its key selling point – to wean patients toward lower or less frequent doses over time, and see if the drug still remains effective.
    • This ‘…could offer a big advantage over Wegovy and Zepbound, since patients on those drugs need to inject them every week indefinitely and tend to rapidly regain weight if they stop taking them.’
    • Nonetheless, the drug’s potency may lead to a greater proportion of patients having to deal with side effects, with the potential of higher drop out rates.
    • Randy Seeley, director of the Michigan Nutrition Obesity Research Center, noted the ‘…competitive landscape among these various molecules will be some about who produces the most weight loss, some of it will be about cost, some it will be about these other health benefits.’ Exactly!
  • Daniel Engberger at The Atlantic recounts Barb’s story, a 60 year old weighing 400 pounds with diabetes, chronic kidney disease and additional health concerns.
    • Losing over 100 pounds on fen-phen in July 1997… the drug being banned by the FDA as a cause of heart valve disease… rapid weight regain… bariatric surgery in 2001 down to below 200 pounds… starting on Trulicity [an early GLP-1 drug], and more recently Mounjaro.
    • And on to large scale health policy efforts… calorie labelling on restaurant menus, soda taxes, and Michelle Obama’s Let’s Move program.
    • Renown economist Eric Finkelstein notably states ‘…Our public-health efforts to address obesity have failed.
    • In addition, ‘…Employer-based wellness programs (which are still offered by 80 percent of large companies) were shown to have zero tangible effects.
    • Health-care spending, in general, kept going up.’
    • So, are we at Ozempic or Bust?  
  • I am encouraged to read Jamie Ducharme’s article in TIME this week titled No One Knows How to Talk About Weight Loss Anymore – spot on!
    • The author continues ‘…Weight loss has always been a fraught topic. But it’s especially complex to talk about in 2024, as body-positivity movements collide with the popularity of drugs like Ozempic, Wegovy, and Zepbound.’
    • Adding that ‘…weight loss is all over the news and social media—and nobody, it seems, knows exactly how to feel or talk about that.’
    • Interestingly, ‘…A recent New York Times article highlighted the tricky situation some body-positivity influencers face when they get smaller, with their followers sometimes viewing weight loss as a betrayal.’
    • Dr. Silvana Pannain, director of the University of Chicago Medicine’s weight-loss program and an advisor to companies that make GLP-1 drugs, thinks that social media and the buzz about GLP-1 drugs are now amplifying it.
    • She states ‘…It’s not necessarily a different way of thinking, but that more people feel the right to voice their opinion about obesity.’
  • Betsy McKay at The Wall Street Journal on keeping weight off, after losing it on a GLP-1 drug.
    • The reporter considers endoscopic balloon therapy, from Fractyl Health.
    • To be really frank, the only permanent solution to treat obesity is bariatric surgery – consider the analogy between surgical excision of a breast cancer, and chemotherapy to keep it at bay – the medical therapy does not remove the cancer… but surgery does.
    • Sure – there is always a possibility of recurrent disease even with surgery, but is less likely if you have removed the tumor in entirety.
    • Let’s think of this when we want to treat obesity and its related co-morbidities.

DATA

  • Dr. Kimberly Gudzune, of Johns Hopkins School of Medicine in Baltimore presented this week at the American Association of Clinical Endocrinology annual meeting, in a post hoc analysis of the SURMOUNT-1 trial, from MedPage Today.
    • Dr. Gudzune notes of participants who failed to shed 5% of their body weight at 12 weeks, more than 90% ultimately achieved that clinically meaningful level of weight loss at 72 weeks.
    • But only 30% dropped at least 15% of their body weight at 72 weeks, compared to 84% of the early responders – those who lost at least 5% at 12 weeks.
    • Put another way, 1 in 6 of the early responders failed to lose at least 15% in weight at 72 weeks, compared to over two-thirds of the slow responders.
    • My take – we should focus care upon early responders, in order to maximize benefit across a population; which is further exacerbated by cost, supply and access issues.
  • IQVIA notes from over 100 million scripts nationally, ‘…GLP-1 agonists account for an increasing share of drugs sold through illegal online pharmacies, growing from 1.1% in 2019 to over 7% in 2023.
    • The report from the IQVIA Institute for Human Data Science states this is ‘…a concerning trend, as poison control centers received over 2,900 calls related to the GLP-1 agonist semaglutide (Ozempic, Wegovy, Rybelsus) in 2023 – 15 times the number of calls in 2019.’
    • There was rising use of novel obesity drugs, with nearly 700K GLP-1 agonist new prescriptions across diabetes and obesity in February 2024, up 181% compared to two years prior.
  • The KFF Health Tracking Poll finds that about one in eight adults (12%) say they have ever taken a GLP-1 agonist… including 6% who say they are currently taking such a drug.
    • In addition, the public has greater awareness of GLP-1 meds, with ‘…about one-third (32%) of adults now saying they have heard a lot about these drugs, up from 19% in July 2023.’
    • Among those who have taken the drugs, ‘…six in ten (62%) say they took them to treat a chronic condition like diabetes or heart disease… [though] four in ten (38%) adults who have taken these drugs report using them only to lose weight.
    • A nice overview, with compelling data, on what we pretty much know already.

DR.RAJESH TWENTLY 30 HEALTH


ADDITIONAL TOPICS

  • Reuters on US FTC seeks more information on Novo Nordisk parent-Catalent deal.
  • Samhita Mukhopadhyay asks at The Cut: So Was Body Positivity ‘All a Big Lie’? If thin is in again — and we have “miracle drugs” to get us there — can we still love ourselves at any size?
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