How ‘miracle’ weight‐loss semaglutide promises to change medicine but can we afford the expense?

British Journal of Pharmacology, Год журнала: 2025, Номер unknown

Опубликована: Фев. 13, 2025

Obesity is a complex and growing global concern, affecting one in eight individuals compromising health, quality of life expectancy. It carries significant metabolic, cardiovascular, oncological, hepatorenal, skeletal psychiatric risks, imposing substantial costs on health‐care systems. Traditional treatments have often been ineffective or led to relapse after lifestyle changes. Whereas bariatric surgery effective, it also involves risks such as mortality hospitalisation. Semaglutide, licensed 2018, synthetic analogue glucagon‐like peptide 1 which regulates glucose metabolism gastrointestinal (GI) motility. Studies show that semaglutide, administered either weekly subcutaneously, daily orally, induces an average weight loss −11.62 kg compared placebo reduces waist circumference by up −9.4 cm. improves blood pressure, fasting levels, C‐reactive protein levels lipid profiles. The most common adverse events are mild‐to‐moderate GI complaints occurring more frequently with administration than doses; hypoglycaemia without intervention. Weight regain follows semaglutide withdrawal. Furthermore, offers cardiovascular benefits for patients established atherosclerotic disease (CVD), lowers the risk kidney outcomes cardiovascular‐related death, resolves nonalcoholic steatohepatitis many cases, positively impacts mental health life. In conclusion, therapy could significantly benefit adults regarding CVD if made widely accessible. Ethical financial considerations must be addressed personalised obesity treatment approaches.

Язык: Английский

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Safety profile of semaglutide versus placebo in the SELECT study: a randomized controlled trial

Obesity, Год журнала: 2025, Номер unknown

Опубликована: Фев. 13, 2025

Abstract Objective The objective of this study was to assess safety once‐weekly subcutaneous semaglutide 2.4 mg versus placebo, beyond reduction in major adverse cardiovascular events, patients with established disease and overweight or obesity. Methods Safety data focused on serious events (SAEs), all (AEs) leading permanent treatment discontinuation irrespective seriousness, prespecified AEs special interest seriousness. Tests differences were determined by two‐sided p values. Results proportion SAEs lower placebo (33.4% vs. 36.4%; < 0.001), primarily driven cardiac disorders (11.5% 13.5%; 0.001). higher (16.6% 8.2%; a difference gastrointestinal (10.0% 2.0%); however, proportions due similar (3.6% 4.1%). Suicide/self‐injury low balanced between groups (0.11% both groups). Gallbladder‐related more frequent (2.8% 2.3%; = 0.04), mainly cholelithiasis (1.4% 1.1%), whereas cholecystitis (0.6% 0.6%). Conclusions long‐term profile observed the Semaglutide Effects Cardiovascular Outcomes People Overweight Obesity (SELECT) is consistent previously reported studies. No new concerns identified for mg.

Язык: Английский

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Glucagon-like peptide-1 receptor agonists and risk of suicidality among patients with type 2 diabetes: active comparator, new user cohort study

BMJ, Год журнала: 2025, Номер unknown, С. e080679 - e080679

Опубликована: Фев. 26, 2025

Abstract Objective To determine whether the use of glucagon-like peptide-1 (GLP-1) receptor agonists is associated with an increased risk suicidal ideation, self-harm, and suicide among patients type 2 diabetes compared dipeptidyl peptidase-4 (DPP-4) inhibitors or sodium-glucose cotransporter-2 (SGLT-2) inhibitors. Design Active comparator, new user cohort study. Setting Primary care practices contributing data to UK Clinical Practice Research Datalink linked Hospital Episodes Statistics Admitted Patient Care Office for National Death Registration databases. Participants Patients diabetes. Exposures Two cohorts were assembled, first composed who started continued on GLP-1 DPP-4 between 1 January 2007 31 December 2020 second SGLT-2 2013 2020. Both followed until 29 March 2021. Main outcome measures The primary was suicidality, defined as a composite suicide. Secondary outcomes each these events considered separately. Propensity score fine stratification weighted Cox proportional hazards models fitted estimate hazard ratios 95% confidence intervals (CIs) average treatment effect treated patients. Results included 36 082 agonist users (median follow-up 1.3 years) 234 028 inhibitor 1.7 years). In crude analyses, incidence suicidality (crude rates 3.9 v 1.8 per 1000 person years, respectively; ratio 2.08, CI 1.83 2.36). This decreased null value after confounding factors accounted (hazard 1.02, 0.85 1.23). 32 336 1.2 96 212 Similarly, in analyses 4.3 2.7 years; 1.60, 1.37 1.87) but not (0.91, 0.73 1.12). Similar findings observed when analysed separately both cohorts. Conclusions this large study,

Язык: Английский

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Obesity and cardiometabolic disease: Insights from genetic studies

Canadian Journal of Cardiology, Год журнала: 2025, Номер unknown

Опубликована: Фев. 1, 2025

Язык: Английский

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The Effect of Glucagon-Like Peptide-1 Receptor Agonists on Measures of Suicidality A Systematic Review

Journal of Psychiatric Research, Год журнала: 2025, Номер 183, С. 112 - 126

Опубликована: Фев. 6, 2025

Reports submitted to the FDA and EMA suggest that Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RAs) may be associated with an elevated risk of suicidality. To ascertain this association across available pharmacovigilance cohort studies, Pubmed, Medline, Cochrane Library, PsychInfo, Embase, Scopus, Web Science were searched from database inception November 20, 2024 in accordance PRISMA guidelines. A manual search using Google Scholar was also conducted identify additional studies. Cohort studies assessed for quality Newcastle-Ottawa Scale. We endeavored define operationalize suicidality as suicide ideation (SI), attempts (SA), completion (SC), cases where study authors failed separate these three dimensions, term "suicidality" applied. 22 meeting inclusion criteria comprised (n = 10) 12) identified. Pharmacovigilance indicate semaglutide liraglutide are disproportionate reporting SI. Results GLP-1 RAs not consistently increase any aspect suicidality; instead, some agents decreased SI SA. There is inadequate information whether causality exists linking Ongoing vigilance further required inform if possibility exists. Practitioners prescribing should vigilant emergence aware higher mental illness persons who would candidates (e.g. Type 2 Diabetes, obesity).

Язык: Английский

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Risk of depression and dementia among individuals treated with sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists

Current Opinion in Psychiatry, Год журнала: 2025, Номер unknown

Опубликована: Фев. 20, 2025

Purpose of the review To whether sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists decrease risk depression, suicidal ideation cognitive impairment in later life. Recent findings The results studies using information derived from large registries administrative health datasets suggest that GLP-1 (RAs) increase suicidality, although have been inconsistent. One nested-case control study reported SGLT2i decreases depression among adults with diabetes, a small trial empagliflozin provided supportive evidence. Several observational RAs dementia risk, target finding greater benefit associated use compared other medicines commonly used to manage diabetes. Summary RA may effects these on mood not as well explored, but there are concerns about potential increased suicidality users. Prescription bias could explain some associations, so robust evidence is now needed confirm or dismiss findings.

Язык: Английский

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Exploring Connections Between Weight‐Loss Medications and Thyroid Cancer: A Look at the FDA Adverse Event Reporting System Database

Endocrinology Diabetes & Metabolism, Год журнала: 2025, Номер 8(2)

Опубликована: Март 1, 2025

ABSTRACT Aims GLP‐1 receptor agonists, such as semaglutide (Ozempic) and tirzepatide (Monjaro), have gained significant popularity for obesity management, but concerns arisen about their potential link to thyroid cancer. This study investigates the association between cancer weight‐loss medications. Materials Methods A disproportionality analysis was conducted using data from FDA Adverse Event Reporting System (FAERS) 2004 Q1 2024. odds ratios (RORs) were used identify associations drugs, including anti‐diabetic Results Significant positive with found agonists: (ROR = 7.61, 95% CI: 6.37–9.08), dulaglutide 3.59, 3.03–4.27), liraglutide 15.59, 13.94–17.44) 2.09, 1.51–2.89). weak inverse observed metformin 0.58, 0.36–0.93). No other topiramate, dapagliflozin insulin glargine. Conclusion The study, based on FAERS database, suggests a agonists an increased risk. These findings underscore importance of further research continuous safety monitoring when prescribing these medications management.

Язык: Английский

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Weight Reduction with GLP-1 Agonists and Paths for Discontinuation While Maintaining Weight Loss

Biomolecules, Год журнала: 2025, Номер 15(3), С. 408 - 408

Опубликована: Март 13, 2025

Worldwide, nearly 40% of adults are overweight and 13% obese. Health consequences excess weight include cardiovascular diseases, type 2 diabetes, dyslipidemia, increased mortality. Treating obesity is challenging calorie restriction often leads to rebound gain. Treatments such as bariatric surgery create hesitancy among patients due their invasiveness. GLP-1 medications have revolutionized loss can reduce body in obese by between 15% 25% on average after about 1 year. Their mode action mimic the endogenous GLP-1, an intestinal hormone that regulates glucose metabolism satiety. However, drugs carry known risks and, since use for recent, may unforeseen well. They a boxed warning people with personal or family history medullary thyroid carcinoma multiple endocrine neoplasia syndrome 2. Gastrointestinal adverse events (nausea, vomiting, diarrhea) fairly common while pancreatitis obstruction rarer. There be lean mass well premature facial aging. A significant disadvantage using these high rate regain when they discontinued. Achieving success pharmacologic treatment then weaning avoid future negative effects would ideal.

Язык: Английский

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Mental Health Factors in Semaglutide Discontinuation

JAMA Internal Medicine, Год журнала: 2025, Номер unknown

Опубликована: Март 17, 2025

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Язык: Английский

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Mental Health Factors in Semaglutide Discontinuation—Reply

JAMA Internal Medicine, Год журнала: 2025, Номер unknown

Опубликована: Март 17, 2025

In Reply We thank Endo and Kami for their comments raising these questions in response to our post hoc analysis of the psychiatric safety semaglutide, 2.4 mg, weight management persons without known major psychopathology, as evaluated STEP 1, 2, 3, 5 studies.1

Язык: Английский

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