A new oral GLP-1 medication, orforglipron, developed by Eli Lilly, could revolutionize weight loss for individuals with type 2 diabetes. The drug, which targets the same GLP-1 receptors as oral semaglutide, offers a non-injection alternative to popular weight-loss drugs like Wegovy and Mounjaro. In a recent clinical trial, orforglipron demonstrated impressive results, helping patients lose up to 8% of their body weight, compared to the 4-5% weight loss associated with semaglutide. This breakthrough could be a game-changer for those seeking a more convenient and potentially cost-effective treatment option.
The trial, known as the Achieve-3 trial, involved over 1,500 adults with type 2 diabetes from various countries. Participants were prescribed either orforglipron or semaglutide, with doses ranging from 12mg to 36mg for orforglipron and 7mg to 14mg for semaglutide. The study revealed that orforglipron not only facilitated greater weight loss but also led to lower average blood sugar levels at the end of the trial period. However, it's important to note that higher discontinuation rates were observed in the orforglipron groups, with approximately 9-10% of participants discontinuing treatment due to side effects, primarily gastrointestinal issues.
The findings have sparked excitement among experts in the field. Tam Fry, chair of the National Obesity Forum, suggests that orforglipron could become a preferred treatment for severely obese diabetics, emphasizing its ease of use. However, he also highlights the need for strict control over its availability to prevent potential misuse and life-threatening consequences, drawing attention to the dangers associated with the misuse of diabetes drugs like Ozempic.
Dr. Marie Spreckley from the MRC epidemiology unit at the University of Cambridge emphasizes the importance of considering higher discontinuation rates due to adverse events, particularly gastrointestinal symptoms, which could impact the medication's tolerability and adherence in real-world scenarios. She also points out that the trial's one-year duration leaves unanswered questions about long-term safety, cardiovascular outcomes, and sustained effectiveness.
Despite these considerations, Naveed Sattar, a professor of cardiometabolic medicine at the University of Glasgow, views the findings as significant. He believes that the development of more effective oral medications for weight loss in type 2 diabetes patients is crucial. Sattar also advocates for holistic approaches that address weight, blood sugar, and cardiovascular risk simultaneously, suggesting that incretin-based therapies could become first-line treatments for type 2 diabetes within the next decade, potentially leading to remission for many patients.
