Weight-loss drugs are being evaluated for their ability to treat diseases such as dementia and addiction, after a landmark study showed Wegovy helped reduce the risk of heart attack and stroke.
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LONDON — Scientists have started investigating whether so-called miracle obesity drugs could be used to treat diseases such as dementia and alcohol dependence, after recent trials showed the drugs to be effective in the treatment of serious health problems.
Advanced trial data released last month by Novo Nordisk said its Wegovy weight loss injection resulted in a “significant reduction” in heart failure-related symptoms in at-risk patients.
This comes weeks after the Danish pharmaceutical company published the results of its long-awaited ‘SELECT’ study, which showed the drug’s role in reducing the risk of major cardiovascular events such as heart attacks or strokes. .
These results mark a major step as the company seeks to broaden awareness of its product – dubbed by some a “vanity drug” – and the researchers hope they will bring positive news for other applications of these drugs.
“The results show that this drug may have health benefits beyond the short term,” said Christian Hendershot, director of the clinical and translational research program in drug addiction at the University of North Carolina at Chapel Hill. , to CNBC via Zoom.
Drug and alcohol abuse treatment
Hendershot is one of the researchers investigating whether the appetite-regulating mechanisms at play in weight-loss drugs could be used to treat other conditions such as alcohol and drug addiction.
Wegovy by Novo Nordisk and Elie LillyMounjaro works by mimicking a natural gut hormone that helps regulate appetite in the brain, ultimately leading to weight loss. For this, they rely on active ingredients called semaglutide and liraglutide respectively, which belong to a group of medicines called GLP-1 receptor agonists.
Data from preclinical trials have for several years underscored the effectiveness of GLP-1 drugs in reducing drug and alcohol consumption in animals. Hendershot is currently testing Ozempic – Wegovy’s predecessor used to treat type 2 diabetes – to see if these trends also apply to humans.
“There are reasons for optimism, especially given the reports. It is now up to us to conduct research to validate these findings with clinical data,” said Hendershot, who hopes to publish the first results next year.
If broader applications of these drugs prove effective, the implications could be vast, according to Kyle Simmons, professor of pharmacology and physiology at Oklahoma State University, who cited early indications of effectiveness drugs to reduce cocaine, amphetamine and opioid cravings. .
Simmons is currently leading the Semaglutide Therapy for Alcohol Reduction (STAR) trial, a 12-week, double-blind, placebo-controlled study, which is running in tandem with a separate but similar study at the University of Baltimore.
“While these two studies are both positive, it’s hard to overstate the effect this will have on the ground,” he said.
Applications in Alzheimer’s disease
Some researchers hope these drugs might also have use cases in treating dementia and other cognitive disorders.
There is already evidence to suggest that GLP-1 drugs can reduce the buildup of amyloid and tau in the brain – two proteins thought to be responsible for Alzheimer’s disease, the most common type of dementia.
Now an ongoing trial at the University of Oxford will test patients at risk of developing dementia – meaning those with high levels of amyloid in the brain – to see if the drugs lead to a reduction in tau accumulation and brain inflammation.
“We want to see if these drugs interfere with the basic pathology of Alzheimer’s disease,” said Ivan Koychev, the principal clinician scientist leading the study.
Elsewhere, others think the drugs could have potential applications in treating polycystic ovary syndrome (PCOS), a disorder that can cause irregular periods, hormonal imbalances and fertility problems.
“If women with PCOS show positive results for irregular periods and hirsutism [excess hair growth] despite modest weight loss, this could underscore the broader therapeutic potential of the drug,” said Harshal Deshmukh, consultant endocrinologist and clinical lecturer at the University of Hull, who is currently leading one such trial.
Implications for reward signaling
However, other possible use cases for weight-loss drugs could exacerbate the barriers already faced by patients using them: high costs and supply shortages.
Earlier this month, Novo Nordisk extended restrictions on starter doses of Wegovy due to production constraints, while Eli Lilly warned of continued delays in Mounjaro production for the same reason.
Hendershot said his study was not currently affected by any shortages, but Simmons described it as a “significant concern”.
Meanwhile, concerns have been raised about possible adverse effects of these drugs after some patients reported thoughts of suicide or harming themselves.
Novo Nordisk CEO Lars Fruergaard Jorgensen told a Reuters Newsmaker event last month that the number of suspected cases remained small compared to the broad reach of the drug. “When you have a drug that’s been used in millions of patients and in many different types of patients, then you may have different events,” he said.
However, Simmons said more research is still needed to understand the impact of these drugs on reward signaling in the brain. His own research will test these signals by monitoring participants’ reward responses in a virtual reality simulation.
“Does this drug, due to its effects possibly on the mesolimbic dopaminergic system, simply reduce the gain in reward signaling in a way that might promote anhedonia?” Simmons said. Anhedonia is a term used to describe a reduced ability to experience pleasure.
“If this drug is used by more and more people, if it starts to promote a loss of interest in pleasure more generally, that might not be a good thing, for example for people with a history major depressive disorder,” he said. added.
If you are having suicidal thoughts, contact the Suicide and crisis lifeline in the United States at 988 or Samaritans in the UK on 116 123.