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Health & Medicine
Mahesh

15/07/24 12:30 PM IST

India could soon allow ‘game-changing’ weight-loss drug tirzepatide

In News
  • Last week, in a first, an expert committee of India’s drug regulator gave the green light to the drug tirzepatide. 
Diabetes drug
  • In 2017, the US Food and Drugs Administration (FDA) approved Danish pharma giant Novo Nordisk’s Ozempic, with the active ingredient semaglutide, to manage type 2 diabetes. Soon, doctors in the US saw an interesting side-effect — weight loss.
  • They started prescribing Ozempic off-label (the practice of prescribing a drug for a different purpose than what has been approved) to treat obesity.
  • This made Novo Nordisk explore semaglutide as a weight loss drug for people without diabetes. In 2021, the company released Wegovy, a semaglutide injection, as an FDA-approved obesity treatment. The key difference between Ozempic and Wegovy: the maximum approved dose of semaglutide is slightly higher with Wegovy than Ozempic.
  • Currently, there is a global shortage of both drugs amid soaring demand.
Semaglutide vs tirzepatide
  • The FDA has approved Wegovy (semaglutide) and Zepbound (tirzepatide) for chronic weight management in adults.
  • These drugs can be prescribed to those who are obese (with a body mass index of over 30), or overweight (with a BMI between 27 and 30), and have at least one other health condition related to their weight (such as high blood pressure, high cholesterol, or type 2 diabetes).
  • Both are administered as under-the-skin injections, and are intended to be used alongside a reduced-calorie diet and increased physical activity.
  • The dosage is increased gradually, reaching a maximum dosage of 2.4 mg for semaglutide and 15 mg for tirzepatide.
  • This does not, however, mean that the latter is ‘stronger’ than the former.
  • Semaglutide and tirzepatide are polypeptides, small proteins that boost the levels of naturally-occurring hormones in the body, including that of glucagon-like-peptide 1 (GLP-1), which control weight through the brain and digestive tract.
  • Higher GLP-1 levels, released in the gut, spark a reaction by stimulating neurons that alter gut function, leading to a sense of fullness.
  • This process also taps into a brain mechanism that lights up neural pathways, triggering the sensation of satiety — the feeling of being satisfied and having had enough to eat.
  • They also help manage glucose levels, making them an effective treatment for diabetes.
  • Semaglutide only targets GLP-1 receptors. On the other hand, tirzepatide also boosts a second hormone: glucose-dependent insulinotropic polypeptide (GIP).
  • The GIP also regulates weight through receptors in brain and fat cells. Eli Lilly claims that the combined action of GLP-1 and GIP enhance each other’s effects.
Side effects of the drug
  • According to the company, Zepbound’s most common side effects include nausea, diarrhoea, vomiting, constipation, abdominal pain, indigestion, injection-site reactions, fatigue, allergic reactions, belching, hair loss, and heartburn.
  • Eli Lilly specifically highlights the risk of thyroid tumours, including thyroid cancer.
  • The possible symptoms, such as a lump or swelling in the neck, hoarseness, trouble swallowing, or shortness of breath.
  • Individuals cannot use Zepbound if they, or any family members, have ever had medullary thyroid carcinoma (MTC), a type of thyroid cancer, or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), a rare, inherited disorder that affects the endocrine glands.
  • Zepbound is a prescription medicine. It cannot — and should not — be used for cosmetic weight loss
  • Improvements in heart and metabolic health seen during the treatment period also tended to revert to baseline levels once the treatment was stopped.
Source- Indian Express

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