Ozympic and other medications are effective at controlling blood sugar and weight loss. Now, scientists are investigating whether they could make the same difference in treating a wide range of other conditions, from addiction and liver disease to infertility.
“It’s kind of snowballed,” said Lindsay Allen, a health economist at Northwestern Medicine. As the drugs get stronger, she says, “they leave this completely changed landscape.”
Most research on other uses of semaglutide, the compound in Ozympic and Wegovi, and tirzepatide, the ingredient in Monjaro and Zepbond, are only in early stages. One of the big questions scientists want to answer is: Are the benefits of these drugs just weight loss? Or do they have other effects that help treat other ailments, such as reducing inflammation in the body or quieting the brain’s compulsive thoughts?
We may not know anytime soon. “We’re still learning how these drugs work,” said Dr. Daniel Drucker, one of the first researchers to study these drugs. (Dr. Drucker consults for Novo Nordisk, which makes Ozympic and Wegovin.)
The following people, many of whom have good treatment options, could benefit permanently if these trials are successful. And for weight-loss drug makers, each new benefit can propel the drugs to blockbuster status. Some of these applications — including those for heart disease and sleep apnea, which each affect tens of millions of people — have become targets of these companies and can be particularly lucrative. These drugs are “a gold mine,” says Dr. Allen. “There is no limit to where the market can go.”
As evidence emerges from these studies, researchers will gain a clearer understanding of exactly how these drugs work in the body. If you can treat many diseases, you can shake the medicine again.
Alcohol use problem
The case
Alcoholism is commonly known as alcoholism. About 30 million people in the United States The situation was in 2022. But it is Rare to examine people, and often it is difficult for them to get unusual treatment. There are effective drugs on the market, but some people can use them They don’t even know that they exist.
Capacity
Some people who take drugs like Ozympic say that the drugs cause them to reduce, and in some cases completely eliminate, alcohol. Researchers are trying to find out the reason. When people take these drugs, they feel full and may lose their appetite for alcohol or food. In addition, because these drugs target the parts of the brain that control appetite, they may affect compulsive behaviors that may involve brain regions such as alcohol or stimulants, gambling, smoking, or nail biting.
Early evidence
one A little research They followed six people with alcohol use disorders who were taking semaglutide for weight loss. All six drank moderately after taking the drug for one to nine months. as if Online survey In a study of 153 obese adults, most of whom were white and female, those who took semaglutide or tirzepatide reported significantly less weight loss than their peers who did not take the drugs.
Although data is limited, some patients with alcohol use disorders are beginning to ask doctors about these medications. Researchers who study how these drugs affect drinking have recently answered the question A piece Reminding naturopathic doctors not to use drugs for alcohol use disorder without further research.
Polycystic ovary syndrome
The case
as many Five million people in the United States have polycystic ovary syndrome or PCOS. The condition is a major cause of infertility and causes irregular periods. There are treatments — diet and exercise changes, birth control pills and the diabetes drug metformin — but they don’t work for everyone.
Capacity
Researchers believe that high levels of testosterone contribute to PCOS. When people with the condition lose weight, their testosterone levels often drop. Medications like Ozempic can help regulate hormones in people with PCOS, says Dr. Melanie Cree, who is leading one of the first studies to investigate whether semaglutide can address PCOS symptoms.
Early evidence
A A little research Of 27 people with obesity and PCOS who took a low dose of semaglutide, after six months most of the participants had lost weight and had more regular periods, suggesting that PCOS was under better control. Dr. Kree has completed a study of semaglutide in adolescent girls with PCOS that showed similar results, and is recruiting another woman to focus on menstrual regularity.
Liver disease
The case
as long as 70 percent People aged 50 and over with type 2 diabetes 90 percent of people Non-alcoholic fatty liver disease, or NAFLD, occurs when excess fat accumulates in the liver. Some patients need it because the condition can cause serious damage to the liver Liver transplant.
Capacity
Doctors typically urge obese or overweight patients with NAFLD to lose weight to reduce the amount of fat and inflammation in the liver. Because drugs like Ozempic help people lose weight, they can also reduce the amount of fat stored in the liver. Type 2 diabetes It increases the risk of NAFLD. By treating it, drugs like Ozempic can reduce the risk or severity of liver disease.
Scientists have two other theories about how the drugs help: by improving insulin resistance, which is common in people with NAFLD, and by reducing inflammation that can damage the liver.
Early evidence
A Research funded by Novo Nordisk Compared with placebo, semaglutide did not significantly improve liver scarring or resolution of nonalcoholic steatohepatitis or NASH, severe nonalcoholic fatty liver disease. The study included patients with cirrhosis or scarring and permanently damaged livers. Big An experiment funded by Novo Nordisk In the past, patients taking semaglutide were more likely to see resolution of NSH than those on placebo, but less likely to see improvement in their scarring.
Novo Nordisk is running one now. In fact, a large clinical trial On semaglutide and NASH, the Food and Drug Administration has designated the drug as a “discovery therapy” for the disease, prompting regulatory review. Researchers funded by Eli Lilly They are investigating whether tirzepatide can treat NASH.
Cardiovascular problems
The case
Heart disease He was killed In the year About 700,000 people in the United States by 2022, making it the nation’s leading cause of death. Experts say there is an urgent need for new treatments that reduce heart disease and stroke and improve symptoms such as fatigue and shortness of breath; This can make the day go by for people with heart disease.
Capacity
Being overweight greatly increases the risk of cardiovascular disease, which is why some doctors think that weight loss can treat and prevent heart problems. The drugs can help by reducing inflammation, which can lead to plaque formation in the heart and blood clots.
Early evidence
In November, a large trial showed that semaglutide reduced the risk of events such as heart attack and stroke in obese and overweight heart patients by 20 percent. Another test People with obesity and certain congestive heart failure have found that semaglutide improves symptoms and makes exercise easier. Eli is Lily. Conducting own experiments On tirzepatide and heart failure. And more studies are underway: Researchers are investigating whether semaglutide can. Reduce the plaque in the heart, Improving symptoms Heart failure or Reduce injuries from strokes.
Sleep apnea
The case
Supposedly 30 million People in the United States suffer from sleep apnea, which stops breathing during sleep and starts during sleep. Treatments such as continuous positive airway pressure, or CPAP, machines can help, although patients are often uncomfortable. Many people with sleep apnea are undiagnosed. If not treated properly, the disease can cause serious damage to people’s health and can increase complications such as heart disease and type 2 diabetes.
Capacity
Sleep apnea is more common in obese people. This is due to a complex combination of factors, including the fact that fat deposits around the neck can block the airway when a person sleeps. Research has shown weight loss, incl Bariatric surgeryIt can help.
Early evidence
There is very little information so far, although an Eli Lilly spokesperson said the company in 2016 A study of tirzepatide and sleep apnea is expected to be completed in the spring of 2024. Novo Nordisk is not currently studying whether semaglutide can treat sleep apnea.
Kidney disease
The case
approx One in three Adults with type 2 diabetes have chronic kidney disease, which is when the kidneys are damaged and cannot function properly. Patients with the disease may eventually need dialysis or a kidney transplant, and if left untreated, the disease can be fatal.
Capacity
Kidney damage is gradual and irreversible in all cases, said Dr. George Bakris, who participated in the Novo Nordisk-funded trial of semaglutide in people with type 2 diabetes and chronic kidney disease. Medications like Ozempic can prevent further damage, because weight loss can reduce the risk of high blood pressure and type 2 diabetes, which are associated with chronic kidney disease.
It is not entirely clear how these drugs improve chronic kidney disease, but one possible reason is that they can reduce inflammation, which is very harmful to people with the disease.
Early evidence
Novo Nordisk announced in October It has halted trials of semaglutide in people with type 2 diabetes and chronic kidney disease after preliminary analysis showed the drug was effective, although the company has not yet released the data. It is the company. Funding for other research To investigate how semaglutide works in the kidney. Eli is Lily. Funding a trial of tirzepatide in people with obesity and chronic kidney disease.
These and other studies are part of what Dr. Howard Forman, a Yale School of Medicine professor specializing in health policy, calls “an explosion of opportunities.”
It remains to be seen whether those possibilities will lead to new treatments.
“We’re very early in this whole industry and it doesn’t surprise me at all,” Dr. Forman said.