Tirzepatide [GLPORA, GDIP] - Mounjaro - 14.7% weight loss at 72 weeks
All quick weight loss medications may have the following adverse effects : osteopenia, sarcopenia, vitamin deficiencies
The researchers used a random sample of 16 million patients from the PharMetrics Plus database between 2006 and 2020, a timeframe that covers the FDA approvals for weight-loss indication with liraglutide in 2014 and semaglutide in 2021. They ensured every case had an obesity code in the 90 days before or up to 30 days after entry into the study. Patients with a diabetes diagnosis or an antidiabetic drug code were excluded. The results, published in JAMA (2023 Oct 5. doi:10.1001/jama.2023.19574), suggested that use of semaglutide and liraglutide for weight loss is associated with an increased risk for pancreatitis (adjusted hazard ratio [aHR], 9.09; 95% CI, 1.25-66.00), gastroparesis (aHR, 3.67; 95% CI, 1.15-11.90) and bowel obstruction (aHR, 4.22; 95% CI, 1.02-17.40) compared with naltrexone-bupropion. The incidence of pancreatitis per 1,000 patients was higher for both GLP-1 agonists relative to naltrexone-bupropion (semaglutide, 4.6 per 1,000; liraglutide, 7.9 per 1,000; and naltrexone-bupropion, 1.0 per 1,000). The incidence of gastroparesis—an AE that could not only cause nausea and vomiting, among other symptoms, but also could affect endoscopic procedures (see box)—was also higher for the GLP-1 agonists (semaglutide, 9.1/1,000; liraglutide, 7.3/1,000; and naltrexone-bupropion, 3.1/1,000). The incidence of bowel obstruction was higher in patients on liraglutide (8.1/1,000) than semaglutide (zero) or naltrexone-bupropion (1.7/1,000). The researchers noted that a main limitation was the study’s observational nature, and while they included only GLP-1 agonist users with a record of obesity, they indicated it is uncertain whether GLP-1 agonists were used specifically for weight loss in each case.
Underscoring the implications of these potential AEs, Dr. Grunvald told Gastroenterology & Endoscopy News, “these adverse events are rare, but given the potential number of people that will use them, absolute numbers of serious adverse events will not be trivial.” Nevertheless, he added, “I also strongly believe, based on emerging data and my own clinical experience, the overall benefits outweigh these risks in general.”
About two-thirds of adults who were prescribed an obesity medication stop taking them after 6 months, and 80% discontinued use at 1 year, according to a retrospective cohort study.
Wegovy (semaglutide, Novo Nordisk) had the highest persistence rate, with 40% of people continuing use after 1 year.
In its quarterly report, which was released on Tuesday, the agency revealed it is looking into p Potential safety signals of popular weight-loss drugs like Ozempic (semaglutide, Novo Nordisk), Wegovy (semaglutide, Novo Nordisk) Mounjaro (tirzepatide, Eli Lilly), Zepbound (tirzepatide, Eli Lilly) and Saxenda (liraglutide, Novo Nordisk).
Semaglutide and liraglutide are both GLP-1 receptor agonists, whereas tirzepatide is a GIP/GLP-1 dual agonist, which has a different mechanism of action.