In the foreseeable future it should be available not only for injection but also as a tablet.
Semaglutid has caused a stir around the world in recent months. The active ingredient, which mimics the effect of the body’s own glucagon-like peptide-1, leads to a feeling of satiety and slower gastric emptying. As an injection that can be administered under the skin (subcutaneously) once a week, the drug leads to the desired blood sugar reduction in type 2 diabetics and to a reduction of the medium-term meaningful value for blood sugar control (HbA1c) by 1.2 to 1.8 percentage points. At the same time, clinical studies have also shown a weight loss effect of minus 15 percent of body weight.
Semaglutide supply shortage
Weight reduction has led to veritable semaglutide hype in the USA. In the United States, there were even supply bottlenecks for diabetics due to off-label use of the drug as a weight loss aid. That also made its way to Europe. “We currently have a supply bottleneck for a diabetes drug, semaglutid, because we noticed that it can also be used to lose weight,” said David Francas, professor of data and supply chain analysis at the university Worms in Germany. “It gets hyped, and suddenly you have an off-label use for the drug, which can also drive demand.”
Next step in development
The active ingredient has been approved in Europe as a diabetes drug since 2018 to lower blood sugar levels. New, from early 2022, is an EU approval specifically for use in weight loss and management under a different brand name. It is intended for people with a body mass index (BMI) from 30, i.e. obese, and for overweight people (BMI from 27) with at least one weight-related comorbidity. For the time being, however, the drug was not even available as a medicinal weight loss aid in European countries.
But now the next stage of development seems to have been reached: while semaglutide was initially only available in a form for injection under the skin, the Danish pharmaceutical company Novo Nordisk has now also developed a version in tablet form. Of course, this would make taking it much easier, especially for people with obesity.
Weight loss by 15.1 percent
According to Novo Nordisk, the scientific data seem to support it. “In a study that enrolled nearly 700 obese or overweight adults who took one pill of semaglutide daily, there was a 15.1 percent weight loss compared to 2.4 percent with placebo over a 17-observation period months,” wrote the pharmaceutical information service “Fierce” recently. That would correspond pretty much exactly to the weight loss effect that has also been proven in clinical studies for the injectable form of the drug. The most common – moderate – side effects are gastrointestinal problems, such as nausea, vomiting and diarrhea. In addition, there is apparently also a potentially increased risk of retinal damage in diabetics.
The matter also has an economic side: Novo Nordisk, the European pharmaceutical company that created the first possibility for the causal treatment of type 1 diabetes around a hundred years ago with insulin, was already extremely successful thanks to Semaglutid, according to “Fierce Pharma”. It increased its sales by around a quarter within a year.
In the meantime, the US company Eli Lilly, which has also been active in the diabetes sector for decades, has started a competitive study on drug-based obesity therapy. Its GLP-1 active ingredient tirzepatid is to be compared with semaglutide. In any case, the Danish group wants to submit its weight loss medication in tablet form for approval in the USA and the EU this year. The relevant market is huge. According to Statistics Austria (data from 2019), 16.5 percent of Austrians are obese (body mass index; BMI over 30).
