Investigating the Potential of Obesity Drugs for Treating Other Conditions
LONDON — Scientists have started studying whether obesity drugs known as “miracle drugs” could be effective in treating conditions such as dementia and alcohol addiction. Recent trials have shown promising results in using these drugs to address serious health issues.
Last month, Novo Nordisk released late-stage trial data showing that their weight loss injection, Wegovy, led to significant reductions in symptoms related to heart failure in high-risk patients.
This breakthrough comes after Novo Nordisk published the results of their highly anticipated “SELECT” study, which demonstrated the drug’s ability to reduce the risk of major cardiovascular events like heart attacks and strokes.
These findings are a major milestone for Novo Nordisk, as they aim to expand the applications of their product beyond its reputation as a “vanity drug.” Researchers are optimistic that these positive results could pave the way for using these drugs to treat other conditions.
“The results show that this medication can have health benefits above and beyond the short-term,” said Christian Hendershot, director of the clinical and translational addiction research program at the University of North Carolina at Chapel Hill.
Exploring Treatment for Drug and Alcohol Abuse
Hendershot is one of the researchers investigating whether the appetite-regulating mechanisms of weight loss drugs can be used to treat alcohol and drug addiction. Novo Nordisk’s Wegovy and Eli Lilly’s Mounjaro imitate a naturally occurring gut hormone that regulates appetite in the brain, leading to weight loss. These drugs rely on active ingredients called semaglutide and liraglutide, which belong to a group of drugs known as GLP-1 receptor agonists.
Pre-clinical trial data has shown for years that GLP-1 medication can reduce drug and alcohol intake in animals. Hendershot is now conducting tests with Ozempic, the predecessor to Wegovy used for treating type 2 diabetes, to see if these trends apply to humans as well.
If those two studies both readout … it’s hard to overstate the effect this will have on the field.
Kyle Simmons
Professor of Pharmacology and Physiology at Oklahoma State University
“There is reason for optimism, particularly given the reports. Now it’s our job to do the research to validate those findings with clinical data,” said Hendershot, who expects to publish early findings next year.
If the broader applications of these drugs prove to be effective, it could have significant implications. Early indications suggest that these drugs can reduce cravings for cocaine, amphetamines, and opioids, according to Kyle Simmons, professor of pharmacology and physiology at Oklahoma State University.
Simmons is currently leading the Semaglutide Therapy for Alcohol Reduction (STAR) trial, a 12-week, double-blind, placebo-controlled study. A similar study is also being conducted at the University of Baltimore.
“If those two studies both show positive results, it’s hard to overstate the impact this will have on the field,” Simmons stated.
Potential Applications in Alzheimer’s Disease
Some researchers believe that these drugs could also be used to treat dementia and other cognitive disorders. There is already evidence suggesting that GLP-1 drugs can reduce the build-up of amyloid and tau proteins in the brain, which are associated with Alzheimer’s disease, the most common form of dementia.
A trial is currently underway at the University of Oxford to test patients at risk of developing dementia, specifically those with high levels of amyloid in the brain, to determine if these drugs can reduce tau accumulation and brain inflammation.
“We want to see if these drugs are interfering with the core pathology of Alzheimer’s disease,” said Ivan Koychev, a senior clinical researcher leading the study.
Furthermore, some experts believe that these drugs could be used to treat polycystic ovary syndrome (PCOS), a disorder that causes irregular periods, hormone imbalances, and fertility issues.
“If women with PCOS experience positive outcomes in terms of irregular periods and excess hair growth despite modest weight loss, it could highlight the broader therapeutic potential of these medications,” said Harshal Deshmukh, a consultant endocrinologist and senior clinical lecturer at the University of Hull, who is conducting a trial for this purpose.
Implications for Reward Signaling
However, expanded use cases for weight loss drugs may worsen the existing challenges faced by patients, such as high costs and supply shortages.
Novo Nordisk recently extended restrictions on starter doses of Wegovy due to production constraints, while Eli Lilly warned of continued delays in Mounjaro output for the same reason.
Hendershot stated that the shortage is not currently affecting his study, but Simmons expressed concern about it, calling it a “significant concern.”
Additionally, there have been concerns about potential adverse effects of these drugs, as some patients have reported suicidal thoughts or self-harm.
Is this medication … turning down the gain on reward-signaling
Kyle Simmons
Professor of Pharmacology and Physiology at Oklahoma State University
Novo Nordisk CEO Lars Fruergaard Jorgensen stated that the number of suspected adverse events remains minimal considering the widespread use of the drug. “When you have medicine that’s used in millions of patients, and many different types of patients, then you can come across different events,” he explained.
However, Simmons emphasized the need for further research to understand the impact of these drugs on reward signaling in the brain. His own research will involve monitoring participants’ reward responses in a virtual reality simulation.
“Is this medication, because of its effects on the mesolimbic dopamine system, simply reducing the sensitivity of reward signaling in a way that could promote anhedonia?” Simmons questioned. Anhedonia refers to a reduced ability to experience pleasure.
“If more and more people start using this drug and it begins to diminish interest in pleasure more generally, it may not be beneficial for individuals with a history of major depressive disorder,” he added.
If you are having suicidal thoughts, contact the Suicide & Crisis Lifeline in the U.S. at 988 or the Samaritans in the U.K. at 116 123.