Fourteen years in the past, the older drug cousin of semaglutide (Ozempic and Wegovy) got here onto the market.
The drug, liraglutide, is offered beneath the model names Victoza and Saxenda.
Patents for Victoza and Saxenda have now expried. So different drug corporations are working to develop “generic” variations. These are seemingly be a fraction of present price, which is round A$400 a month.
So how does liraglutide evaluate with semaglutide?
How do these medicine work?
Liraglutide was not initially developed as a weight-loss therapy. Like semaglutide (Ozempic), it initially handled kind 2 diabetes.
The category of medicine liraglutide and semaglutide belong to are referred to as GLP-1 mimetics, that means they mimic the pure hormone GLP-1. This hormone is launched out of your small intestines in response to meals and acts in a number of methods to enhance the way in which your physique handles glucose (sugar).
How do they cease starvation?
Liraglutide acts in a number of areas of the unconscious a part of your mind, particularly the hypothalamus, which controls metabolism, and components of the mind stem liable for speaking your physique’s nutrient standing to the hypothalamus.
Its actions right here seem to cut back starvation in two other ways. First, it lets you really feel full earlier, making smaller meals extra satisfying. Second, it alters your “motivational salience” in the direction of meals, that means it reduces the quantity of meals you hunt down.
Liraglutide’s unique formulation, designed to deal with kind 2 diabetes, was marketed as Victoza. Its means to trigger weight reduction was evident quickly after it entered the market.
Shortly after, a stronger formulation, known as Saxenda, was launched, which was supposed for weight reduction in individuals with weight problems.
How a lot weight are you able to lose with liraglutide?
Folks reply in another way and can lose totally different quantities of weight. However right here, we’ll word the common weight reduction customers can anticipate. Some will lose extra (generally way more), others will lose much less, and a small proportion will not reply.
The primary GLP-1 mimicking drug was exenatide (Bayetta). It is nonetheless out there for treating kind 2 diabetes, however there are presently no generics. Exenatide does present some weight reduction, however that is fairly modest, usually round 3-5 p.c of physique weight.
For liraglutide, these utilizing the drug to deal with weight problems will use the stronger one (Saxenda), which generally provides about 10 p.c weight reduction.
Semaglutide, with the stronger formulation known as Wegovy, usually ends in 15 p.c weight reduction.
The most recent GLP-1 mimicking drug available on the market, tirzepatide (Mounjaro for kind 2 diabetes and Zepbound for weight reduction), ends in weight lack of round 25 p.c of physique weight.
What occurs once you cease taking them?
Regardless of the effectiveness of those drugs in serving to with weight reduction, they don’t seem to alter individuals’s weight set-point.
So in lots of circumstances, when individuals cease taking them, they expertise a rebound towards their unique weight.
What’s the dose and the way usually do it is advisable to take it?
Liraglutide (Victoza) for kind 2 diabetes is strictly the identical drug as Saxenda for weight reduction, however Saxenda is a better dose.
Though the goal for every formulation is similar (the GLP-1 receptor), for glucose management in kind 2 diabetes, liraglutide has to (primarily) attain the pancreas.
However to attain weight reduction, it has to succeed in components of the mind. This implies crossing the blood-brain barrier – and never all of it makes it, that means extra needs to be taken.
All the present formulations of GLP-1 mimicking drug are injectables. This would possibly not change when liraglutide generics hit the market.
Nonetheless, they differ in how often they should be injected. Liraglutide is a once-daily injection, whereas semaglutide and tirzepatide are once-weekly. (That makes semaglutide and tirzepatide way more engaging, however we can’t see semaglutide as a generic till 2033.)
What are the negative effects?
As a result of all these medicines have the identical goal within the physique, they largely have the identical negative effects.
The most typical are a spread of gastrointestinal upsets together with nausea, vomiting, bloating, constipation and diarrhoea. These happen, partially, as a result of these drugs gradual the motion of meals out of the abdomen, however are usually managed by growing the dose slowly.
Latest scientific knowledge suggests the slowing in emptying of the abdomen might be problematic for some individuals, and should improve the chance of of meals coming into the lungs throughout operations, so it is very important let your physician know in case you are taking any of those medicine.
As a result of these are injectables, they’ll additionally result in injection-site reactions.
Throughout scientific trials, there have been some reviews of thyroid illness and pancreatitis (irritation of the pancreas). Nonetheless, it’s not clear that these might be attributed to GLP-1 mimicking medicine.
In animals, GLP-1 mimicking medicine medicine have been discovered to negatively alter the expansion of the embryo. There may be presently no managed scientific trial knowledge on their use throughout being pregnant, however primarily based on animal knowledge, these medicines shouldn’t be used throughout being pregnant.
Who can use them?
The GLP-1 mimicking medicine for weight reduction (Wegovy, Saxenda, Zepbound/Mounjaro) are accepted to be used by individuals with weight problems and are supposed to solely be used together with food regimen and train.
These medicine should be prescribed by a physician and for weight problems are usually not lined by the Pharmaceutical Advantages Scheme, which is likely one of the the explanation why they’re costly. However in time, generic variations of liraglutide are prone to be extra inexpensive.
Sebastian Furness, ARC Future Fellow, College of Biomedical Sciences, The College of Queensland
This text is republished from The Dialog beneath a Artistic Commons license. Learn the unique article.
