US obesity docs expect Lilly weight-loss drug to show similar heart
benefit as Wegovy
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[December 02, 2023]
By Patrick Wingrove
(Reuters) -Some leading U.S. obesity specialists say they expect Eli
Lilly’s powerful weight-loss drug Zepbound will produce the same or
similar heart benefits as Novo Nordisk’s popular Wegovy as they belong
to the same class of medicines.
The views of the five doctors, all senior physicians practicing obesity
medicine at top universities and hospitals, indicate that Novo's drug is
not likely to have a significant edge based on its heart benefits, even
though it will be years before Lilly produces similar cardiovascular
data. Both medicines are GLP-1 agonists, a class originally designed to
treat type 2 diabetes.
In Novo's pivotal Wegovy trial involving 17,604 overweight and obese
people without diabetes, the drug reduced incidence of heart attack,
stroke or heart-related death by an impressive 20%.
The Danish drugmaker said study participants’ heart health improved
almost immediately, indicating the drug’s impact was not just from
weight loss.
"I would anticipate that the cardioprotection with Wegovy would extend
to Zepbound," said Dr. Edmond Wickham, an endocrinologist and associate
professor at Virginia Commonwealth University.
![](http://archives.lincolndailynews.com/2023/Dec/02/images/ads/current/xamis_sda_HFH_2023.png)
The U.S. Food and Drug Administration on Nov. 8 approved Zepbound for
weight loss. The product, which has the same active ingredient -
tirzepatide - as its previously approved diabetes drug Mounjaro, is
expected to start shipping it before the end of the year. Wall Street
analysts expect Lilly to reap in about $2 billion in sales from Zepbound
in 2024. Barclays analyst Emily Field forecast $7.3 billion in 20224
sales for Wegovy.
Six doctors Reuters spoke with said they are more likely to prescribe
Zepbound when it becomes available over Wegovy.
But revenue and which drug doctors prescribe in the short term may come
down to available supplies, which are expected to be outpaced by
skyrocketing demand for both Wegovy and Zepbound.
Analysts have said the weight-loss drug market could be worth $100
billion by the end of the decade.
The specialist doctors said they would prefer to prescribe Zepbound
because it helped patients lose an average of 20% of their weight in its
late-stage trial compared to 15% for Wegovy.
They said they would readily prescribe Wegovy (semaglutide) if their
patients' insurance did not cover Lilly’s drug, or if future trial
results do not produce similar heart benefits.
HEAD-TO-HEAD TRIALS
Lilly is enrolling for a cardiovascular outcomes trial to examine
tirzepatide's impact on heart health in patients without type 2 diabetes
with data expected in 2027, and completed enrollment for a similar trial
in patients with type 2 diabetes, with data expected in 2024.
![](http://archives.lincolndailynews.com/2023/Dec/02/images/ads/current/castlemanor_sda_FINANCIAL_2017.png)
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![](../images/120223PIX/health16.jpg)
An Eli Lilly and Company pharmaceutical manufacturing plant is
pictured at 50 ImClone Drive in Branchburg, New Jersey, March 5,
2021. REUTERS/Mike Segar
![](http://archives.lincolndailynews.com/2023/Dec/02/images/ads/current/peasley_lda_051513.png) "We anticipate that both studies
will help us learn about the impact of tirzepatide on
cardiovascular-related and other outcomes relevant to these patient
populations," Lilly said in an emailed statement.
The U.S. drugmaker is also running a head-to-head trial pitting
Zepbound against Wegovy in overweight or obese patients with other
weight-related health issues. That data is expected in 2025.
Lilly declined to comment on doctors' views that Zepbound might have
the same or similar cardiovascular benefits as Wegovy.
Tirzepatide was also shown to be better at lowering blood sugar in
adults with type 2 diabetes compared to semaglutide, the active
ingredient in Wegovy, in a head-to-head study from 2021, one doctor
noted.
“All things being equal, then you potentially give Zepbound because
there is a greater degree of weight loss and a greater reduction in
the blood sugars,” said Dr. Rohit Kedia, an endocrinologist at the
large West coast-based healthcare system Providence.
Extended periods of high blood sugar can damage blood vessels and
the nerves that control a person’s heart.
A study published on medRxiv in advance of peer review this week
found overweight or obese adults lost more weight and shed pounds
faster using Lilly's Mounjaro than those taking semaglutide, which
is also the active ingredient in Ozempic.
Novo said it could not speculate on competitors and that its trial
specifically investigated the effect of semaglutide and not other
GLP-1s.
Dr. Chad Weldy, a cardiologist at Stanford University, said
semaglutide showed the strongest evidence of preventing
cardiovascular events like heart attack and stroke. He said he
expected tirzepatide to show a similar benefit. For now, he prefers
Wegovy, he said.
![](http://archives.lincolndailynews.com/2023/Dec/02/images/ads/current/napa_sda_HFH_2023.png)
“If I prescribed semaglutide but insurers pushed back and wanted me
to start tirzepatide, I would not have any problems with that,” he
added.
Weldy pointed to a similar scenario with a different class of
diabetes drugs, the SGLT-2 inhibitors.
AstraZeneca’s Farxiga was first shown to lower the risk of heart
failure, but eventually Boehringer Ingelheim and Lilly’s Jardiance
demonstrated a nearly identical benefit.
Jardiance sales rose nearly $2 billion the year after the heart
benefits were added to its label.
(Reporting by Patrick Wingrove; Editing by Caroline Humer and Bill
Berkrot)
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