"Those now-familiar medications target a pathway involving the appetite-regulating hormone GLP-1; the new ones target cell receptors for a different hormone, amylin. AstraZeneca, Eli Lilly, Zealand Pharma, and, of course, Novo Nordisk, which makes Ozempic, are all testing amylin-based obesity drugs. And if the increasing number of new weight-loss medications seems hard to choose from, you might not have to pick just one. Some medications in development, such as CagriSema, go one step beyond, combining components that target amylin and GLP-1 to make even more powerful drugs."
"In a recent trial, individuals with obesity who took an amylin-based drug called cagrilintide lost about 12 percent of their weight over the course of 16 months. Those on semaglutide, the active ingredient in Ozempic, lost about 15 percent. Those taking CagriSema lost, on average, more than 20 percent. (By comparison, bariatric surgery, a dramatic procedure that reconfigures the digestive system, can cause a person to lose about 30 percent of their weight-but it comes with the possibility of serious complications such as hernias and life-threatening infections.)"
New weight-loss medications target different hormonal pathways: existing drugs act on GLP-1 receptors and commonly cause nausea in about half of users, while emerging drugs act on amylin receptors and appear to cause fewer bothersome side effects. Major pharmaceutical companies are testing amylin-based obesity drugs, and combination medicines such as CagriSema combine amylin and GLP-1 mechanisms to amplify weight loss. Clinical trials showed cagrilintide led to roughly 12% weight loss over 16 months, semaglutide about 15%, and CagriSema over 20%. These drugs approach the effectiveness of bariatric surgery but raise questions about appropriate limits and risks.
Read at The Atlantic
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