Fourteen years in the past, the older drug cousin of semaglutide (Ozempic and Wegovy) got here onto the market.
The drug, liraglutide, is bought beneath the model names Victoza and Saxenda.
Patents for Victoza and Saxenda have now expried. So different drug corporations are working to develop “generic” variations. These are possible be a fraction of present price, which is round A$400 a month.
So how does liraglutide evaluate with semaglutide?
How do these medicine work?
Liraglutide was not initially developed as a weight-loss remedy. Like semaglutide (Ozempic), it initially handled sort 2 diabetes.
The category of medicine liraglutide and semaglutide belong to are often called GLP-1 mimetics, which means they mimic the pure hormone GLP-1. This hormone is launched out of your small intestines in response to meals and acts in a number of methods to enhance the way in which your physique handles glucose (sugar).
How do they cease starvation?
Liraglutide acts in a number of areas of the unconscious a part of your mind, particularly the hypothalamus, which controls metabolism, and components of the mind stem answerable for speaking your physique’s nutrient standing to the hypothalamus.
Its actions right here seem to scale back starvation in two alternative ways. First, it lets you really feel full earlier, making smaller meals extra satisfying. Second, it alters your “motivational salience” in the direction of meals, which means it reduces the quantity of meals you hunt down.
Liraglutide’s authentic formulation, designed to deal with sort 2 diabetes, was marketed as Victoza. Its potential to trigger weight reduction was evident quickly after it entered the market.
Shortly after, a stronger formulation, known as Saxenda, was launched, which was supposed for weight reduction in individuals with weight problems.
How a lot weight are you able to lose with liraglutide?
Folks reply in another way and can lose totally different quantities of weight. However right here, we’ll word the typical weight reduction customers can anticipate. Some will lose extra (typically far more), others will lose much less, and a small proportion will not reply.
The primary GLP-1 mimicking drug was exenatide (Bayetta). It is nonetheless obtainable for treating sort 2 diabetes, however there are presently no generics. Exenatide does present some weight reduction, however that is fairly modest, sometimes round 3-5 p.c of physique weight.
For liraglutide, these utilizing the drug to deal with weight problems will use the stronger one (Saxenda), which generally provides about 10 p.c weight reduction.
Semaglutide, with the stronger formulation known as Wegovy, sometimes leads to 15 p.c weight reduction.
The most recent GLP-1 mimicking drug in the marketplace, tirzepatide (Mounjaro for sort 2 diabetes and Zepbound for weight reduction), leads to weight lack of round 25 p.c of physique weight.
What occurs while you cease taking them?
Regardless of the effectiveness of those drugs in serving to with weight reduction, they don’t seem to alter individuals’s weight set-point.
So in lots of circumstances, when individuals cease taking them, they expertise a rebound towards their authentic weight.
What’s the dose and the way typically do you want to take it?
Liraglutide (Victoza) for sort 2 diabetes is precisely the identical drug as Saxenda for weight reduction, however Saxenda is a better dose.
Though the goal for every formulation is identical (the GLP-1 receptor), for glucose management in sort 2 diabetes, liraglutide has to (primarily) attain the pancreas.
However to realize weight reduction, it has to achieve components of the mind. This implies crossing the blood-brain barrier – and never all of it makes it, which means extra must be taken.
All the present formulations of GLP-1 mimicking drug are injectables. This may not change when liraglutide generics hit the market.
Nevertheless, they differ in how steadily they should be injected. Liraglutide is a once-daily injection, whereas semaglutide and tirzepatide are once-weekly. (That makes semaglutide and tirzepatide far more enticing, however we cannot see semaglutide as a generic till 2033.)
What are the uncomfortable side effects?
As a result of all these medicines have the identical goal within the physique, they largely have the identical uncomfortable side effects.
The commonest are a spread of gastrointestinal upsets together with nausea, vomiting, bloating, constipation and diarrhoea. These happen, partly, as a result of these drugs sluggish the motion of meals out of the abdomen, however are typically managed by rising the dose slowly.
Latest scientific knowledge suggests the slowing in emptying of the abdomen could be problematic for some individuals, and will enhance the chance of of meals getting into the lungs throughout operations, so it is very important let your physician know in case you are taking any of those medicine.
As a result of these are injectables, they’ll additionally result in injection-site reactions.
Throughout scientific trials, there have been some reviews of thyroid illness and pancreatitis (irritation of the pancreas). Nevertheless, it’s not clear that these could be attributed to GLP-1 mimicking medicine.
In animals, GLP-1 mimicking medicine medicine have been discovered to negatively alter the expansion of the embryo. There’s presently no managed scientific trial knowledge on their use throughout being pregnant, however primarily based on animal knowledge, these medicines shouldn’t be used throughout being pregnant.
Who can use them?
The GLP-1 mimicking medicine for weight reduction (Wegovy, Saxenda, Zepbound/Mounjaro) are accepted to be used by individuals with weight problems and are supposed to solely be used together with weight-reduction plan and train.
These medicine should be prescribed by a physician and for weight problems will not be lined by the Pharmaceutical Advantages Scheme, which is without doubt one of the the reason why they’re costly. However in time, generic variations of liraglutide are more likely to be extra reasonably priced.
Sebastian Furness, ARC Future Fellow, Faculty of Biomedical Sciences, The College of Queensland
This text is republished from The Dialog beneath a Artistic Commons license. Learn the authentic article.
