“It is a day to celebrate how the lives of many people living with obesity and diabetes have changed, and also to thank the parents of the molecule and to the patients who have participated in their research. With these words, the endocrinologist Cristóbal Morales has celebrated the announcement that the Princess of Asturias Award for Scientific and Technical Research 2024 will be awarded to the developers of semaglutide, the active ingredient of the very famous medicine Ozempic.
Morales describes the 16 years in which he has worked with this molecule, and the rest of the GLP-1 agonist family, as a “nice story of scientific research.” These drugs were known to be an effective treatment for type 2 diabetes and, in recent years, as an injection miracle for weight loss. However, GLP-1 agonists continue to surprise researchers and more and more studies find them useful for the treatment of the most severe diseases.
“I have been caring for patients with obesity, overweight and diabetes for 20 years. Their approach has completely changed since the first GLP-1 agonist appeared in 2008: it was administered twice a day and “went directly to the origin of the metabolic problem, excess adiposity.”, summarizes Morales, who works at the Virgen Macarena University Hospital in Seville. Given the overwhelming number of pathologies on which these molecules are showing an effect, Morales does not hesitate to describe their emergence as “a pharmacological spring.”
Paradigm shift
Apart from representing a “before and after” in obesity and diabetes, these molecules are protagonists of encouraging studies on the decrease in cardiac events and chronic kidney disease, on peripheral arterial disease, addiction treatment, inflammation and neuroprotection. In fact, scientific journals Science and Nature They had already chosen these molecules as the most important scientific advance that had taken place in the year 2023. Despite this, in the coming months they will be in the news again.
“In the coming months, results will be published on the usefulness of these drugs in sleep apnea, neuroprotection, knee osteoarthritis, liver disease and heart attack reduction, because it is being observed that they help reduce pericardial fat, which surrounds the heart,” Morales lists. That is, the first new approved uses that are going to be produced will be related to the consequent benefits of losing fat mass. But the GLP-1 agonists not only confer benefits through this pathway.
Morales explains that this molecule has receptors in many places in the body, such as the brain or kidney, and also has an anti-inflammatory mechanism. “It is an intestinal hormone that “it communicates with the entire body and has multiple effects,” says the expert. Remember that they are very powerful medications that must be prescribed and controlled by expert professionals. However, in recent years its irresponsible consumption to reduce body weight has also been pointed out: “It has been the first influential medicine in history. We must limit messages in this sense from social networks that do not come from healthcare,” he denounces. .
cardiac events
The SELECT study is the most important scientific trial that has proposed to demonstrate the effectiveness of semaglutide in the prevention of cardiovascular events. To do this, they had a total of 17,605 patients who were overweight and obese, but did not suffer from diabetes. Although it had already been proven that cardiovascular events were reduced in the diabetic population, SELECT demonstrated that People without diabetes also benefited: A weekly subcutaneous dose of 2.4 milligrams of semaglutide reduced mortality from cardiovascular disease, heart attack, and stroke, according to The New England Journal of Medicine.
Kidney risk
In turn, the FLOW study, with 3,533 participants, has investigated the effect that semaglutide could have on patients with type 2 diabetes who also suffer from chronic kidney disease. Just two weeks ago, The New England Journal of Medicine published conclusions confirming that the drug was capable of reducing the events of this disease. “Those taking semaglutide had 24% lower risk of having a serious kidney disease event, like losing at least half of your kidney function or needing dialysis or a transplant,” he points out. The New York Times.
Polycystic ovary
A few months ago there were also cases of women with difficulties getting pregnant who managed to do so shortly after starting treatment with Ozempic. This phenomenon is known as Ozempic babies and is related to a possible positive effect of medication on polycystic ovary syndrome. As Morales explained to EL ESPAÑOL in this article, “This syndrome is related to excess fat and makes the woman infertile. It is not the medication itself, but its accompaniment with healthy lifestyle habits that produces a loss of fat mass in these patients and in turn a restoration of natural hormonal cycles. “This improves fertility, we’ve known that for a long time.”
in addictions
People who take Ozempic often report less desire to drink alcohol as well, and this has led some researchers to test its effect on addictions. A scientific study carried out in Denmark found that, of the 130 participants studied, those who received GLP-1 agonists combined with cognitive behavioral therapy They drastically reduced their alcohol consumption compared to those who received a similar psychotherapy, but taking a placebo at the same time.
For dementia
Finally, semaglutide is also being tested in the field of dementia, to which Alzheimer’s disease belongs. Currently, the University of Oxford is carrying out a scientific study that it estimates will end in 2026 and that studies people at risk of Alzheimer’s due to their levels of amyloid protein. The anti-inflammatory power of semaglutide is thought to could interact with the mechanisms of this disease for which there are still no sufficiently effective medications.
Explosion of new drugs
Morales says that this Princess of Asturias award is a great recognition of this avenue of research with GLP-1 agonists and explains that in the near future more powerful, effective and safe medications will come. “Spain is the first country in Europe in clinical trials. It is a reward to the patients who have allowed this to be a reality and the patients of the future to have these treatments. In these trials, Spanish patients have had a decisive importance,” explains the endocrinologist.
“It must be taken into account that large pharmaceutical companies reinvest approximately 30% of their profits in R&D&I. Very successful molecules are being generated and this results in better medications for the future,” explains Morales. “It is a very competitive world. Right now there is a lot of talk about Novo Nordisk or Lilly, which are the most positioned, but each pharmaceutical company is going to try to develop its own molecule. Boehringer, Amgen, Astrazeneca, Pfizer… Each one wants its own drug and the one that has the best results in the end will be the one that reaches the patient the most.”