Oral GLP-1 Charge; Weight Loss Drugs and Cancer; The Obese Police; Medicaid Coverage for Comprehensive Obesity Care.

AT A GLANCE

Structure Therapeutics announced weight loss of 6.2% at 12 weeks in 37 subjects on GSBR-1290 – a once-daily oral GLP-1 drug.
UK-based The Guardian newspaper reports ‘…Weight-loss drugs offer a new weapon in the global fight against cancer…’
STAT notes Eli Lilly’s Zepbound obesity drug ‘…improved living scarring in a mid-stage study of the liver disease MASH.’
Tamar Haspel at The Atlantic refers to new guidelines to endorse people-first language, in her article The Obese Police.
The STOP Obesity Alliance analyzed the state Medicaid coverage data for nutrition counseling, intensive behavioral therapy, obesity medications, and metabolic and bariatric surgery.

NEWS

Structure Therapeutics, a clinical-stage global biopharmaceutical company, announced positive 12-week topline obesity data from its Phase 2a study of GSBR-1290 – an orally-available, small molecule agonist of the glucagon-like-peptide-1 (GLP-1) receptor.
- The once-daily drug achieved a placebo-adjusted mean decrease in weight of 6.2% at 12 weeks in 37 subjects.
- In addition, 67% of GSBR-1290 treated participants achieved greater than or equal to 6% weight loss, and 33% achieved greater than or equal to 10% weight loss, compared to 0% for placebo.
- Founder and CEO Raymond Stevens stated ‘…These topline results demonstrate the substantial weight loss effect of GSBR-1290 and its potential to become a best-in-class oral small molecule GLP-1RA as well as an ideal backbone for future combination therapeutics for the treatment of obesity and related diseases.’
- I do love the approach to combination therapies, just as we do for cancer and other chronic diseases.
- Up next for the Company is a 36-week global study is expected to use the tablet formulation of GSBR-1290 and include approximately 300 participants to be treated with multiple doses and dose titration regimens.
- In addition, Structure is developing next generation combination GLP-1R candidates together with GIP, amylin, glucagon and apelin oral small molecules.
- The key factors are that the weight loss is comparable to injectable GLP-1 peptide drugs, and Eli Lilly’s GLP-1 pill called orforglipron with associated scalability in commercial manufacturing.
From ASCO, or the American Society of Surgical Oncology annual meeting in Chicago last week, UK-based The Guardian newspaper reports ‘…Weight-loss drugs offer a new weapon in the global fight against cancer, with enormous potential to prevent new cases and shrink tumours.’
- A study of 34,000 people, led by the Case Western Reserve University in Ohio, found patients taking the drugs were 19% less likely to develop 13 obesity-related cancers, including ovarian, liver, colorectal, pancreatic, bowel and breast cancer.
- In addition, ‘…patients were half as likely to die over 15 years compared with patients not taking the jabs.’
- Researchers from Memorial Sloan Kettering Cancer Centre in New York said on breast cancer that ‘…the jabs could cut the risk of cancer recurrence and be a new tool against the disease.’
- Dr Jennifer Ligibel, at Dana-Farber Cancer Institute said ‘…These are exciting, preliminary findings of a link between use of GLP-1s and cancer risk.’
Reuters notes Britain considers offering Lilly weight-loss drug on better terms than Wegovy; by not placing a two-year time limit on the medicine’s use as it had for rival Novo Nordisk’s Wegovy.
- For patients with a BMI of at least 35 and at least one weight-related co-morbidity, such as type 2 diabetes or heart disease, it was not appropriate to include a long-term stopping rule for tirzepatide, although it recommended considering stopping treatment if patients lose less than 5% of their initial weight after 6 months – which would be 10-15% of the population, based upon published clinical trial data.
STAT notes Eli Lilly’s Zepbound obesity drug ‘…improved living scarring in a mid-stage study of the liver disease MASH.’
- It is exciting that between 51-55% of patients experienced a greater than one-stage improvement in scarring, or fibrosis, without worsening of their disease, varying according to the dose of the drug.
- This compares to 29.7% of patients on placebo who achieved this outcome, and is statistically significant.

OPINION

Tamar Haspel at The Atlantic refers to new guidelines to endorse people-first language, in her article The Obese Police.
- She says ‘…The world is an awfully inhospitable place for fat people…’ through discrimination, bias and downright cruelty.
- But Tamar is ‘…not at all convinced though, that a diktakt about language will ever make a dent in deeply entrenched enmity.’
- The author continues ‘…Using people with obesity will not make much difference in the end. But the policing of language and, by extension, the ideas that it expresses, certainly might.’

DATA

The STOP Obesity Alliance analyzed the state Medicaid coverage data for plan year 2023, with both the Medicaid Fee for Service and top Medicaid Managed Care plans for each state were analyzed.
- The review included the categories of comprehensive obesity care: nutrition counseling, intensive behavioral therapy, obesity medications, and metabolic and bariatric surgery.
- Overall, obesity treatment coverage was not covered in fourteen states, twenty-nine states had restrictive coverage, eight states had limited coverage, and no single state covered obesity care.
- In more detail, twenty-two states did not provide coverage for nutritional counseling, one state failed to provide any coverage for intensive behavioral therapy, obesity medications were not covered in thirty-two states, and only two states did not provide coverage for metabolic and bariatric surgery.
- Across all evidence-based obesity treatments, no state provided coverage for comprehensive obesity care, with all states applying various levels of exclusions, limitations, or restrictions for the coverage of obesity treatments.
Medscape reports on Dr. Sever of the University Medical Centre in Ljubljana, Slovenia, who presented semaglutide enhances taste sensitivity, changes brain responses to sweet tastes, and may even alter expression of genes in the tongue associated with taste bud development, at the 2024 Annual Endocrine Society Conference, held in Boston.
- 30 women with polycystic ovary syndrome (PCOS) were randomized to either 1 mg of semaglutide, or placebo for 16 weeks.
- Prior to the intervention, researchers tested participants’ taste sensitivity using 16 taste strips infused with four different concentrations of sweet, sour, salty, and bitter substances.
- At the end of the study, the women taking semaglutide increased their taste sensitivity from 11.9 to 14.4 points.
- I would draw attention to past work from Dr. Carel Le Roux and colleagues who explored changes in food preferences and ingestive behaviors after GLP-1 treatment, and who has extensively studied in patients having undergone bariatric surgery, all the way back to 2010.

ADDITIONAL TOPICS

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