Fourteen years in the past, the older drug cousin of semaglutide (Ozempic and Wegovy) got here onto the market.
The drug, liraglutide, is offered underneath the model names Victoza and Saxenda.
Patents for Victoza and Saxenda have now expried. So different drug firms are working to develop “generic” variations. These are probably be a fraction of present price, which is round A$400 a month.
So how does liraglutide examine with semaglutide?
How do these medicine work?
Liraglutide was not initially developed as a weight-loss therapy. Like semaglutide (Ozempic), it initially handled sort 2 diabetes.
The category of medicine liraglutide and semaglutide belong to are generally known as 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 best way 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 elements of the mind stem chargeable 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 search out.
Liraglutide’s unique formulation, designed to deal with sort 2 diabetes, was marketed as Victoza. Its means to trigger weight reduction was evident quickly after it entered the market.
Shortly after, a stronger formulation, known as Saxenda, was launched, which was meant for weight reduction in folks with weight problems.
How a lot weight are you able to lose with liraglutide?
Individuals reply in another way and can lose totally different quantities of weight. However right here, we’ll observe the typical weight reduction customers can count on. Some will lose extra (typically rather 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 at the moment 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 usually offers 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 available on the market, 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 once you cease taking them?
Regardless of the effectiveness of those drugs in serving to with weight reduction, they don’t seem to alter folks’s weight set-point.
So in lots of instances, when folks cease taking them, they expertise a rebound towards their unique weight.
What’s the dose and the way usually do you’ll want to take it?
Liraglutide (Victoza) for sort 2 diabetes is strictly the identical drug as Saxenda for weight reduction, however Saxenda is the next 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 attain weight reduction, it has to succeed in elements 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 would possibly not change when liraglutide generics hit the market.
Nonetheless, 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 rather more enticing, however we can’t see semaglutide as a generic till 2033.)
What are the unwanted side effects?
As a result of all these medicines have the identical goal within the physique, they principally have the identical unwanted 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 gradual the motion of meals out of the abdomen, however are usually managed by rising the dose slowly.
Latest scientific information suggests the slowing in emptying of the abdomen will be problematic for some folks, and should improve the chance of of meals coming 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). Nonetheless, it’s not clear that these will 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 at the moment no managed scientific trial information on their use throughout being pregnant, however based mostly on animal information, 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 accredited to be used by folks with weight problems and are supposed to solely be used along side weight loss program and train.
These medicine have to be prescribed by a physician and for weight problems aren’t lined by the Pharmaceutical Advantages Scheme, which is likely one of the explanation 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 underneath a Artistic Commons license. Learn the unique article.
