Will We Always Have to “Keep Taking” Obesity Medicines?

Perhaps the most persistent fault that people find with new obesity medicines is the need to keep taking them forever. “Nobody is ready ” for that, says Business Insider.Patients hate forever drugs,” says the New York Times. And they have a point.

Obesity medicine doctors are quick to say “suck it up.” That’s just the way it is. With these medicines, we are treating a chronic disease just like high blood pressure, so if you want to keep it under control, you’ll have to get used to it and keep taking your medicine.

But it might not be quite so cut and dried.

What If?

What if it’s possible to develop medicines that seem a bit more like a vaccine against obesity and less like the chronic medicines people take for blood pressure. That’s the idea that some innovators are pursuing.

Novo Nordisk’s Chief Scientific Officer, Marcus Schindler, told Stat News that they are just beginning to think about this:

“We have a very early think tank on: what would it take us, from a technology point of view and from an ecosystem point of view, to make long-lasting GLP-1 molecules? Could we think about vaccine-like properties, where imagine you had, once a year, an injection with an equivalent of a GLP-1 that really helps you to maintain weight loss and have cardiovascular benefits?”

Maridebart Cafraglutide (MariTide)

Structure of Maridebart CafraglutideFor Amgen, this is more than just a hypothetical. The company is developing a unique dual agonist/antagonist called maridebart cafraglutide. It acts on both GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 receptors. However, this is not the only way in which it is different from existing GLP-1 medicines for obesity.

It is also worth noting that the GIP receptor antagonist part of this drug is actually a fully human monoclonal antibody. Using amino acid linkers, that antibody is bound to two GLP-1 agonist peptides. Yes, that’s a lot to wrap our heads around.

But don’t worry. You won’t have to pass a quiz on peptide biochemistry to get this. Because what matters here is that this is a unique approach and it seems to yield a drug with a very long-lasting effect.

Exactly how long? That is uncertain. In phase 1 studies, Amgen scientists saw effects lasting for five months.

Many a Slip

Remember, even though Amgen has phase 1 data to suggest their medicine might work for a very long time, they still have a lot more to learn. Phase 2 data is due this year and will give us much more confidence that this could work. Even then, there will be plenty of possibilities down the road for maridebart cafraglutide to fail. With a high degree of innovation comes a higher risk of unexpected outcomes. There is many a slip twixt the cup and the lip, as they say.

But this is an exciting possibility. Because getting a shot once or twice a year to prevent obesity from coming back feels very different from having to keep taking a daily pill or a weekly shot of obesity medicines.

Click here for more from Stat News on the concept Novo Nordisk is pursuing and here for more on maridebart cafraglutide.

Inoculation, photograph by John Vachon for the United States Farm Security Administration / Wikimedia Commons

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April 26, 2024