Health Rounds: Next generation Lilly weight-loss drug shows added heart, liver benefits

[September 06, 2024]  By Nancy Lapid

(Reuters) - Eli Lilly's experimental next generation weight-loss drug mimics three hormones instead of just one or two and continues to show promising clinical trial results for additional health benefits, the company said.

Researchers reported at the recent European Society of Cardiology meeting in London that Lilly’s retatrutide significantly reduced patients’ blood lipid levels and cardiovascular risks in a mid-stage trial.

At 48 weeks, for example, retatrutide had reduced levels of triglycerides by up to 40.6%, and levels of a protein called apoC-III involved in glucose metabolism and inflammation by 38%.

Lilly had earlier announced that in the same trial patients taking injections of retatrutide at the highest dose had lost roughly 24% of their body weight, exceeding what the current popular weight-loss drugs demonstrated in clinical trials.

Obese patients in the trial also had significant improvements in their liver fat.

Like tirzepatide, the active ingredient in Lilly’s Mounjaro and Zepbound, and semaglutide, the active ingredient in Wegovy and Ozempic from Novo Nordisk, retatrutide mimics the appetite- and blood-sugar-reducing effects of a hormone called glucagon-like peptide 1, or GLP-1.

Tirzepatide and retatrutide also mimic a second hormone called glucose-dependent insulinotropic polypeptide (GIP) to reduce appetite and blood sugar.

Retatrutide also mimics a third hormone, glucagon, promoting fat breakdown for energy consumption and preventing dangerously low blood sugar levels.

Lilly is currently testing retatrutide in late-stage trials.

Multiple artery-unclogging helps older heart attack patients

Older patients with a common type of heart attack and multiple narrowed coronary arteries should have all of those arteries unclogged, not just the one that caused the heart attack, researchers said at the ESC meeting.

A so-called ST-segment elevation myocardial infarction, or STEMI, is a heart attack that happens when an artery carrying blood to the heart becomes completely blocked. As a result, the heart suffers permanent damage.

When younger patients with a STEMI have multiple other diseased arteries along with the “culprit” artery, doctors often revascularize, or clear out, all of those blood vessels, placing stents as necessary during a catheterization procedure to keep the arteries open.

However, this strategy, which takes longer and potentially raises the risks of complications, is currently underused in older patients, the researchers said.

Analyzing data pooled from seven studies involving 1,733 patients over age 75, researchers found that at four years after the procedure, complete revascularization was associated with a 22% combined reduction in death from any cause, heart attack, or need for another artery-unclogging procedure compared with opening just the culprit artery.

Eli Lilly logo is shown on one of the company's offices in San Diego, California, U.S., September 17, 2020. REUTERS/Mike Blake/File Photo

A few of the patients were followed for roughly six years. By that time, the difference between the groups in the combined endpoint was no longer statistically significant. However, there was still a 24% reduction in the combined rate of heart-related deaths and heart attacks for the complete revascularization group.

There were no significant differences between the groups in procedure-related complications, including stroke, clogged stents, major bleeding, or kidney problems from the use of dye, according to a report of the study published in Circulation.

The researchers are waiting for additional data on study participants to provide further information on longer-term outcomes, Dr. Gianluca Campo of the University Hospital of Ferrara in Italy, who presented the data, said in a statement.

Blood pressure meds can be taken in morning or evening

Whether you take your blood pressure pills in the morning or at night doesn’t matter, a new Canadian study confirms.

In a large analysis reported at the ESC meeting, researchers found the timing of administration made no difference in major cardiovascular events or safety.

“Patients should take their BP medication when they are least likely to forget,” study leader Ricky Turgeon from the University of British Columbia in Vancouver said in a statement.

His team pooled data from five randomized trials that involved a total of 46,606 patients. Across the five trials, rates of major adverse heart problems and all-cause mortality were not affected by evening versus morning dosing, they found.

The same was true for the risks of fractures, glaucoma issues and cognitive events.

Dr. Scott Garrison from the University of Alberta in Edmonton, whose team conducted two of the five trials involving roughly 4,000 patients – including one trial involving frail older patients – reported his team’s findings in a separate presentation at the meeting.

“We know that BP typically follows a circadian rhythm that peaks after waking and troughs during sleep,” he said in a statement. “Major cardiovascular events such as myocardial infarction and stroke are associated more strongly with high BP at night,” which is why some guidelines have called for taking BP meds at bedtime.

But in his team’s two trials, he noted, “while evening dosing was safe, it conveyed no additional advantages.”

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

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