Bimagrumab: Hesitancy and Promise in Obesity Care

HesitationInnovation in obesity care has come a long way. Back in 2010, Sanofi was smarting from the spectacular failure of rimonabant and big pharma was closing down research programs in obesity. But Novo Nordisk forged ahead with an ambitious program and now has a successful portfolio in obesity care to show for it. Nonetheless, we still see hesitancy about investing in obesity innovation from other companies. Bimagrumab is a prime example.

Unique Benefits

A new paper in JAMA Network Open shows tantalizing results with bimagrumab in patients with obesity and diabetes. Patients treated with this monoclonal antibody had a 20.5 percent reduction in fat mass. Net weight loss was modest – 6.5 percent. This is because people gained 3.6 percent in muscle mass from bimagrumab.

These results contrast sharply with results from other obesity treatments. Typically people lose both fat and muscle mass. But bimagrumab has a unique mode of action. It blocks a receptor called activin and stimulates muscle growth. Thus, we’re seeing a significant improvement in body composition with this drug. Waist circumference improved and so did glycemic control.

Sounds great, doesn’t it?

Not So Fast

In 2019, Novartis presented these results at ObesityWeek and caused quite a stir. Yet nothing is happening with bimagrumab. Novartis isn’t saying much about it. In fact, it gets no mention on the company list of new drugs in research. Novartis is “reviewing the program strategy and considering next steps.”

That’s biz speak for doing nothing.

No doubt, they have their reasons. Drug development programs are risky and expensive. Bimagrumab has already failed in studies for other indications. Perhaps Novartis sees issues with safety that make it hesitate to move forward with obesity studies. On the other hand, maybe it’s just not sure the reward for a unique obesity medicine will justify the risk of moving ahead.

Whatever the reason, the result is the same. Inaction.

Lilly hesitated in a similar way with tirzepatide. At one point the company was unsure about developing it for obesity. But now it looks like this new drug may be on the way to becoming a big success. Such is the nature of innovation in obesity care – a mixture of hesitancy and promise.

Click here for the new paper and here for more from Medscape.

Hesitation, painting by Paul Klee / WikiArt

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January 26, 2021

2 Responses to “Bimagrumab: Hesitancy and Promise in Obesity Care”

  1. January 27, 2021 at 10:49 am, MARY H. HAGER said:

    A bit confused. Is this a Novartis or a Novo Nordisk drug?

  2. January 27, 2021 at 11:03 am, Ted said:

    Thanks for asking, Mary. Bimagrumab was an experimental Novartis drug. But right now, it looks like the company has stopped developing it.