The GLP-1 weight loss drugs that are currently popular around the world are highly sought after because of their outstanding effects. However, the gastrointestinal side effects of this drug are increasingly attracting industry attention. Currently, the active ingredients of the most widely used GLP-1 weight loss drugs in the world are semaglutide or liraglutide.
Weight-loss drugs and diabetes drugs such as Wegovy and Ozempic may increase the risk of three rare but serious stomach conditions in people without diabetes, and not all risks are listed in the drug warning labels, according to a new study published Oct. 5 in the Journal of the American Medical Association (JAMA).
GLP-1 drugs suppress a person's appetite by slowing down digestion, but if that process is slowed down too much, it can cause other problems in the body, including a condition called gastroparesis, which slows or completely prevents the movement of food from the stomach to the intestines and can lead to persistent symptoms such as vomiting, the researchers said.
Studies also note that other side effects include an increased risk of intestinal obstruction and pancreatitis. However, these two side effects are clearly listed on the labels of these drugs. "These side effects are not mild, although the incidence is low," the researchers said.
They measured the rates at which patients developed four different serious stomach problems - gastric paralysis, pancreatitis, intestinal obstruction and biliary tract disease (a group of conditions that affect the gallbladder) - while taking semaglutide, liraglutide and bupropion-naltrexone. The results showed that compared with bupropion-naltrexone, GLP-1 was associated with a nine-fold higher risk of pancreatitis, a four-fold higher risk of intestinal obstruction, and a more than three-fold higher risk of gastric paralysis.
Specifically, approximately 7 out of every 1,000 patients develop gastric paralysis while taking liraglutide, and nearly 10 out of every 1,000 patients develop gastroparesis while taking semaglutide.
The study was based on an analysis of health insurance claims records from about 16 million U.S. patients and excluded those who had diabetes or were taking another diabetes medication.
In this regard, Mohit Sodhi, one of the authors of the study, pointed out: "When this number is expanded to the population level, it becomes very large. For example, when more than 1 million people around the world use this drug, based on the incidence of semaglutide, 10,000 people may develop gastroparesis."
The study also showed that pancreatitis occurred in about 5 out of every 1,000 patients when using semaglutide and about 8 out of every 1,000 patients when using liraglutide. In addition, approximately 8 out of every 1,000 patients develop intestinal obstruction while taking these two GLP-1 drugs.
Currently, Novo Nordisk's weekly injection of Wegovy still dominates the global GLP-1 weight loss drug market. The United States is Wegovy's main market. The latest data shows that between 2020 and 2022, U.S. healthcare institutions issued more than 9 million prescriptions for Wegovy and the similar GLP-1 antidiabetic drug Ozempic, with the number of prescriptions increasing by 300% in three years.
Wegovy is priced at up to $1,300 a month and is used by Hollywood celebrities and billionaires including tech tycoon Elon Musk.
The drug has also been sought after by the capital market and users, pushing Wegovy drugmaker Novo Nordisk's profits to a new high and the company's market value soaring. Novo Nordisk's shares have roughly tripled since Wegovy's launch in June 2021. Last month, the Danish drugmaker's market value surpassed that of French luxury goods group LVMH, reaching nearly 400 billion euros, making it Europe's most valuable listed company.
According to forecast data from research firm Berenberg, the Novo Nordisk Foundation will receive a return of approximately US$12.5 billion from 2022 to 2026. That's roughly double what Wegovy made before it launched in the United States.
Novo Nordisk's holding company, Novo Holdings, invests in and manages the assets of the Novo Nordisk Foundation. CEO Kasim Kutay said this week that Novo Nordisk Holdings will receive significant funding over the next decade if market estimates of the company's capital returns are correct.
This also drives Novo Nordisk Holdings' global expansion. As of June this year, the company had 160 employees, up from three in 2009. The company expects the number of employees to increase to 180 next year. Currently, Novo Nordisk Holdings has 6 offices around the world, including an office opened in Shanghai this year, focusing on investment in the Chinese market.