Tag: GLP-1 agonist

Categories : Expert Opinion Medical IndustryTags : Leave a comment

GLP-1 RAs Will Not Solve Diabetes

On By ModernMedia

“South Africa’s diabetes epidemic will not be solved by the next pharmaceutical breakthrough. It will be solved by fundamentally reshaping how healthcare is organised and paid for”

– Lungile Kasapato, CEO of PPO Serve.

Diabetes is now South Africa’s leading killer, accounting for more deaths than HIV and TB combined. Global headlines celebrate GLP-1 receptor agonists (RAs) as a breakthrough for metabolic disease and obesity. But this narrative ignores a fundamental reality: for most South Africans, these drugs are inaccessible. Priced between R3 000 and R6 000 per month, they remain unaffordable. Even as cheaper generics become widely available, they won’t solve the problem alone. Without the clinical infrastructure to support treatment, and the social support to access healthy food, access means little.

“We’re pushing an incomplete solution,” says Lungile Kasapato, CEO of PPO Serve, a healthcare management company implementing value-based care in South Africa for over a decade. “GLP-1 RAs offer real benefits – sustained weight loss, reduced inflammation, lower cardiac risk, protection against comorbidities. For someone facing diabetes, these outcomes matter. But we’re acting as if a drug alone can solve a system failure. It can’t. A medication prescribed into a broken healthcare system is just a product. It’s not a national health strategy.”

The scale of the crisis is staggering. Forty percent of low-income South Africans’ diet consists of ultra-processed foods. Across the broader population, nearly 30% have undiagnosed hypertension. Most discover their condition only after complications like strokes or heart attacks emerge. By the time they reach treatment, the system can only manage disease with medications, never addressing what caused it in the first place. When a GLP-1 RA is prescribed in this fractured environment, initial sustained progress stalls because the infrastructure to maintain results was never built.

“This fragmentation isn’t accidental,” says Kasapato. “It’s structural. Fee-for-service rewards volume, not health. A provider, working alone, gets paid for each visit, test, or procedure – regardless of whether the patient’s health improves. With no teamwork or incentive to coordinate, follow-ups become inconsistent and inadequate. Every encounter is transactional, continuity is impossible, and no one is accountable for the patient actually getting better. As long as we pay for activity instead of results, we won’t fix the system or build the infrastructure these medications need.”

PPO Serve’s The Value Care Team, implemented in partnership with the Government Employees Medical Scheme (GEMS), demonstrates what a different payment structure creates. GPs, nurses, dietitians, and care coordinators work together, sharing accountability for patient outcomes rather than billable procedures. Coordination becomes the norm, and prevention becomes profitable, meaning early intervention can stop complications before they escalate. Medication works better because the system supports it, including addressing the social issues that drive obesity in the first place. This is what reshaping incentives creates.

“The real choice isn’t just about drug access,” says Kasapato. “It’s about payment models, and the system it creates. Cheaper GLP-1 RAs could be available tomorrow – generics are already arriving. But availability achieves little without the organisation to deploy them. The conversation must progress from funding medications to funding the teams and systems that make them work. South Africa’s diabetes epidemic will not be solved by the next pharmaceutical breakthrough. It will be solved by fundamentally reshaping how healthcare is organised and paid for.”

Categories : Mental Health Metabolic DisordersTags : Leave a comment

GLP-1s do not Cause Major Psychiatric Harm, Review Shows

On By ModernMedia
Photo by Haberdoedas on Unsplash

There is no link between the widely used diabetes and obesity medications known as GLP-1 receptor agonists and increased suicidal thoughts, depression or other serious psychiatric harm based on an integrative review of current scientific evidence conducted by researchers at New Mexico State University and the University of Nevada, Las Vegas.

The review, published in the journal Diabetology, traced the earliest concerns raised over GLP-1 RA therapies and found that after subsequent investigations, the medications do not increase psychiatric risk.

“GLP-1 RAs have become a cornerstone treatment for Type 2 diabetes and obesity, now used by tens of millions of patients worldwide,” said Jagdish Khubchandani, a professor of public health at NMSU, who co-authored the study with Kavita Batra, executive director of medical research and scholarly activities at the UNLV Kirk Kirkorian School of Medicine.

Reports that GLP-1s might trigger suicidal ideation, depression or anxiety began appearing  soon after the medications gained mainstream popularity. Those reports then prompted formal safety reviews by the U.S. Food and Drug Administration and the European Medicines Agency, beginning in 2023.

The research team analyzed five years of mechanistic, pharmacovigilance, observational and regulatory evidence to trace how early reports were investigated and how the scientific and regulatory consensus shifted over time. Earlier this year, the FDA removed its suicidality warning from GLP-1 medications.

“When reports of depression and suicidal thoughts first surfaced with GLP-1 RA use, they came from patients and doctors voluntarily reporting what they saw, and such reports can raise a question, but can’t answer it,” Batra said. “Since then, studies following millions of patients, including a pooled analysis of 91 clinical trials, have found no increase in psychiatric risk. But an answer for millions isn’t an answer for everyone. The right response is to screen and check in with each patient, not to take an effective treatment off the table.”

The review found that early warning signals were largely tied to one drug from selected patient groups, while larger controlled studies often pointed in contradictory directions – something the research team attributes to study design rather than the drugs themselves.

Khubchandani said spontaneous adverse-event reports can be skewed by media attention, by the fact that people with obesity and diabetes already have higher baseline rates of depression and suicidality, and by more frequent medical visits among treated patients that create more opportunities for symptoms to be reported. Controlled studies that account for these factors do not show exceptionally high risks, he added.

Still, the review found that some groups using GL-P1s may need closer monitoring. Patients already taking antidepressants or benzodiazepines showed a substantially amplified reporting signal for suicidal ideation, suggesting that any residual risk may be concentrated among those with pre-existing psychiatric vulnerability rather than the general patient population.

“Depression is more common in people with Type 2 diabetes than in the general population, and it works in both directions: Depression makes diabetes harder to manage, and diabetes makes depression more likely,” Batra said. “So, the mood symptoms a patient reports on any diabetes medication may have been there long before the prescription. That’s exactly why asking about mental health should be a routine part of diabetes care, not a special step reserved for when a drug is under suspicion.”

Khubchandani said the pace of research on GL-P1 medications needs to catch up with their pace of usage, particularly among groups like adolescents, those with serious mental illnesses and other groups underrepresented in clinical trials to date.

 “Just like for several other medications, the decision to use GLP-1 RA should include individualized screening of patients for psychiatric history and suicidality before starting treatment, watching more closely for patients with a history of mood disorders or concurrent psychiatric medication use, and educating patients and caregivers to report mood changes promptly,” Khubchandani said.

To read the review, visit https://www.mdpi.com/2673-4540/7/8/144.

Source: New Mexico State University

Categories : Metabolic DisordersTags :

Researchers Examine Unanticipated Benefits of GLP-1 Medications

On By ModernMedia

Editorial highlights emerging benefits and questions surrounding this rapidly expanding class of medications

Photo by Haberdoedas on Unsplash

GLP-1 receptor agonists and dual agonists have transformed the treatment of obesity and other metabolic diseases, and a new editorial co-authored by Dr Steven Heymsfield of LSU’s Pennington Biomedical Research Center and Dr Adam Gilden of the University of Colorado examines what scientists are learning as these medications reach millions of people.

The editorial, “Unanticipated Effects of GLP-1 Receptor Agonists: A Net Positive,” was published in the journal Obesity and highlights additional benefits that were not fully anticipated when the drugs were initially developed.

“Most of the unanticipated side effects of GLP-1 receptor agonists have been positive,” the authors wrote.

The researchers highlight evidence suggesting GLP-1 medications may reduce inflammation and lower the risk of certain cardiovascular and musculoskeletal conditions. Emerging studies also suggest the medications may reduce alcohol consumption and the risk of certain substance use disorders, although additional clinical trials are needed to confirm these effects.

At the same time, questions remain about the medications’ effects on lean body mass and nutritional health. Weight loss associated with GLP-1 medications can include reductions in lean mass, including muscle, making it important to understand how to preserve muscle through exercise and appropriate nutrition. Reduced appetite may also increase the risk of micronutrient deficiencies in some patients.

“GLP-1 receptor agonists have already transformed the practice of medicine in the United States, and this change will continue as more medications come onto the market,” the authors wrote.

The researchers identify three key priorities for future GLP-1 research:

  • Understanding the mechanisms behind potential reductions in inflammation,
  • Conducting randomised trials to better understand changes in lean body mass and ways to preserve muscle,
  • Conducting larger randomised trials to determine whether these medications can reduce alcohol use disorders.

Despite the remaining questions, the authors conclude that the evidence available to date supports a favourable overall risk-benefit profile for GLP-1 receptor agonists and dual agonists.

Source: Pennington Biomedical Research Center

Categories : Cardiovascular Disease Metabolic DisordersTags :

GLP-1 Drug Linked to Heart Benefits for High-risk Patients

On By ModernMedia

Findings from clinical practice will help inform shared decision making

Human heart. Credit: Scientific Animations CC4.0

Adding the GLP-1 receptor agonist drug tirzepatide to standard care for patients with type 2 diabetes and heart disease is associated with a lower risk of a major cardiovascular event, such as a heart attack or stroke, finds a study published by The BMJ today.

Randomised trials and observational studies have shown non-inferior effects of tirzepatide compared to another GLP-1 receptor agonist, dulaglutide, for major adverse cardiovascular events (MACE) – a combined measure of heart attack, stroke, and death from any cause. But evidence on the effects of adding tirzepatide to standard care is more limited, resulting in uncertainty for both regulators and clinicians.

To address this, researchers analysed clinical practice data from two US health insurance claims databases between May 2022 and May 2025. They aimed to estimate the cardiovascular effects of adding tirzepatide to standard care for patients with type 2 diabetes, a body mass index of at least 25, and established heart disease by comparing the outcomes to sitagliptin, another diabetes drug.

Sitagliptin was chosen as a neutral placebo proxy based on several studies showing no effect on cardiovascular outcomes.

The main outcome of interest was a reduction in MACE, which was monitored from the first day of treatment up to one year, or until the individual stopped or switched treatment, or disenrolled from the health plan.

Factors including age, sex, race, body mass index, previous heart problems, other chronic conditions, and medication use were taken into account, and a technique called propensity score overlap weighting was used to balance out differences between the two groups to draw more reliable conclusions.

A total of 52,971 individuals were included in the analysis (average age 70 years; 51% female), of whom 35,353 started tirzepatide and 17,618 started sitagliptin.

At one year, the risk of MACE was 2.9% in the tirzepatide group and 4.4% in the sitagliptin group (a 32% relative reduction), and the researchers estimate that for every 70 patients starting tirzepatide, one case of MACE would be prevented.

For individual MACE components, tirzepatide was associated with a 33% lower risk of heart attack compared with sitagliptin, whereas ischaemic stroke showed no meaningful difference.

Infections requiring hospital admission were also lower with tirzepatide (one admission prevented for every 48 patients), as was infection related death (one death prevented for every 200 patients) and death from any cause (one death prevented for every 122 patients).

This is an observational study, but the researchers previously benchmarked their design, data, and analytics infrastructure against a randomised controlled trial before drawing conclusions about cause and effect.

They also acknowledge several limitations including a relatively short follow-up period, which may underestimate long term cardiovascular and safety effects, possible misclassification of treatment duration or outcomes, and findings may not apply to other healthcare systems or patients without established cardiovascular disease.

However, they conclude: “This study shows how trial-anchored evidence from clinical practice can estimate the expected cardiovascular benefit of initiating tirzepatide beyond standard background treatment and inform shared decision making.”

A linked editorial notes that while this study provides an important, transparent estimate of what initiating tirzepatide might achieve in routine care, it does not establish a mortality indication or define the best sequence for cardiometabolic therapy.

The authors say longer follow-up, randomised and pragmatic comparisons, and more studies of additive benefit on contemporary background treatment are needed. Furthermore, cardiovascular efficacy cannot benefit a population if cost, authorisation barriers, supply, and discontinuation prevent sustained treatment, they add.

As such, they conclude: “The signal is compelling; the causal and clinical placement questions remain open.”

Source: BMJ Group

Categories : Metabolic DisordersTags :

South Africa’s Weight-Management Market Needs Stronger Safeguards for Women

On By ModernMedia

By Dr Gerhard Vosloo, Founder and Head Consulting Practitioner at Dr GL Vosloo Medical Practice, managed by BioWell

Prescription-based weight management treatment has surged into the mainstream, giving more people with genuine clinical needs access to potentially life-changing care. However, the market’s growth has not been matched by consistently high standards of care. This Women’s Month, we must confront the fact that many women remain particularly vulnerable to inadequate clinical oversight, inappropriate prescribing practices, and black-market products that operate outside established medical safeguards.

Nearly seven in ten adult South African women are obese, compared to four in ten men. Women therefore account for a significant share of the weight-management market and, as a result, may face greater exposure to irresponsible medical practices and unregulated black-market options, where proper clinical support and control are virtually non-existent.

At Dr GL Vosloo Medical Practice, managed by BioWell, women make up the majority of patients seeking a holistic weight-loss and metabolic management programme, which may include prescription treatment where clinically justified. Concerningly, some patients arriving from other programmes report excessively high dosages of treatments, with scarce oversight or guidance. Others have used black-market products and later sought professional medical help after struggling to manage their treatment safely and effectively.

These experiences demonstrate exactly why prescription treatment should form part of a broader, medically-supervised programme rather than a medication-only approach. As more women seek treatment, the industry has a duty to help them understand what good clinical care and appropriate dosing practices involve, as well as how to distinguish a medically grounded programme from those built primarily around access to medication.

Not all weight-management programmes are created equal. Patients should look for a few key indicators that suggest a provider is delivering safe, responsible care:

  1. Screening should begin before the consultation

Before the first appointment is even scheduled, a reputable practice or physician should gather sufficient information to understand a patient’s medical history, current health status, and potential risk factors. For example, intake forms may ask about previous weight-loss treatments, allergies, pregnancy or breastfeeding status, eating habits, goals, and other information that may help the practitioner identify contraindications early.

Patients should expect this information to be reviewed before they proceed. Any omissions or concerns should be raised, while patients with possible contraindications, urgent medical issues, or conditions outside the programme’s scope should be informed and referred where necessary.

  1. The consultation should establish clinical need and risk

Patients should expect a thorough consultation that explores their concerns, goals, medical and treatment history, symptoms, and relevant lifestyle or health factors. It should also give the doctor an opportunity to clarify uncertainties, identify undisclosed contraindications, and assess appetite, eating behaviour, level of activity, sleep quality, and mental health.

For women, this may include menstrual health, contraceptive use, pregnancy plans, breastfeeding, menopause, polycystic ovary syndrome, hormone treatment, and previous gestational diabetes.

A medical assessment should establish whether prescription treatment is clinically appropriate, rather than being prescribed simply because a patient wants to lose weight. Relevant considerations may include body measurements, blood pressure, glucose, cholesterol, organ and thyroid function, vitamin and hormone levels, and pregnancy screening where relevant.

  1. Treatment decisions should be fully explained before consent

Doctors should provide a clear explanation of whether prescription therapy is appropriate, whether it should be delayed or avoided, or whether another treatment approach may be more suitable. Prescription-based medication should not be framed as the primary intervention, although it may form part of a broader programme covering nutrition, exercise, behaviour, supplementation, metabolic support, clinical monitoring, and guidance on how these elements work together.

Before written consent is given, patients should be informed about the expected benefits, potential side effects, serious risks, contraindications, alternatives, monitoring requirements, and circumstances under which treatment may be stopped. Women should also be informed about how pregnancy plans, breastfeeding, hormonal treatment, or changing health circumstances may affect whether treatment can begin or continue.

  1. Prescriptions should be individualised and closely monitored

Patients should be cautious of one-size-fits-all prescribing practices. Treatment should reflect the individual’s clinical needs and risk profile, using a conservative approach rather than a standard dose or automatic escalation schedule.

Ongoing follow-up is equally important. Regular check-ins should track progress, side effects, relevant eating and lifestyle factors, and any changes in health or medication use, with treatment adjusted accordingly. For women, this continuity is particularly important because hormonal, reproductive, and life-stage circumstances may change during treatment and affect how care is managed.

Women should not have to navigate a fast-moving treatment market through trial and error. By understanding the characteristics of safe, medically supervised care, patients are better equipped to make informed choices. Ultimately, however, the responsibility rests with practitioners and clinics to make ethical, medically-grounded care easy to recognise from the outset. Public trust in this treatment category will depend on how consistently the industry meets that standard.

Categories : Metabolic Disorders Substance UseTags :

Newer Obesity Drugs Linked to Fewer Alcohol-related Hospitalisations

On By ModernMedia

Use of newer GLP-1 receptor agonists for obesity or diabetes was associated with a reduction in hospital admissions suggesting a potential role for the treatment of alcohol-use disorder

Photo from Pixabay CC0

Use of newer GLP-1 receptor agonists (semaglutide or tirzepatide) for obesity or diabetes by people with alcohol-use disorder was associated with a reduction in alcohol-related admissions to hospital, finds a study published online in the open access journal BMJ Open.

The findings suggest a potential role for the drugs semaglutide and tirzepatide in the treatment of alcohol-use disorder.

While GLP-1 receptor agonists are used primarily for the treatment of type 2 diabetes and obesity, there have been reports of reduced alcohol consumption among patients taking the drugs, prompting the authors to investigate the potential impact on alcohol-related hospitalisations among adults with alcohol-use disorder.

The study compared alcohol-related hospitalisations in 40 703 adults with alcohol-use disorder and type 2 diabetes or obesity who started a newer GLP-1 receptor agonist (semaglutide or tirzepatide) or a comparator drug between 1 January 2018 and 31 December 2024. Participants were split across four trials involving clinically distinct populations – the anti-diabetic medication (ADM) trial, anti-obesity medication (AOM) trial, medications for alcohol use disorder with type 2 diabetes (MAUD- T2D) trial, and medications for alcohol-use disorder with obesity (MAUD-obesity) trial.

Compared to participants taking an active comparator drug, those taking GLP-1 receptor agonists had a lower risk of alcohol-related admission to hospital during all four trials.

Use of GLP-1 receptor agonists was associated with a 26% lower risk of alcohol-related hospital admission than other diabetes medicines during the diabetic medication (ADM) trial, and a 32% lower risk of alcohol-related hospital admission than other obesity medicines during the anti-obesity medication (AOM) trial.

In the MAUD trials, the active comparators were drugs for alcohol-use disorder including acamprosate, disulfiram and naltrexone. Compared with taking drugs for alcohol-use disorder, use of GLP-1 receptor agonists by adults with type 2 diabetes was associated with a 63% lower risk of alcohol-related admission to hospital during the trial, and for adults with obesity use of GLP-1 receptor agonists was associated a 65% lower risk of alcohol-related hospitalisations.

The authors acknowledge several limitations to their study. Most importantly, alcohol-use disorder is under-captured due in part to stigmatisation, and when documented, it may also be recorded variably with lower reporting in areas of high social deprivation. Alcohol-related outcomes may have been under captured as they were defined using diagnosis codes and laboratory testing for alcohol exposure, and the study captured hospitalisations from treatment initiation to discontinuation in a trial environment, so treatment effects in an average clinical setting may differ.

Finally, there may have been some confounding in relation to socioeconomic status, underlying clinical stability or alcohol-use disorder severity, and healthcare engagement, as newer GLP-1 receptor agonists are higher-cost therapies and patients with access to these medications may differ from comparator groups.

The risk of residual confounding was greatest in the MAUD trials, as reflected by the reduced risk of non-alcohol-related hospitalisations with use of GLP-1 receptor agonists. The authors say the results of the MAUD trials should be interpreted with greater caution as there were also high rates of treatment discontinuation increasing the potential for bias.

Nevertheless, the authors conclude, “Initiation of newer GLP-1 receptor agonists among patients with alcohol-use disorder was associated with a lower observed risk of alcohol-related hospitalisation, with similar associations across populations with type 2 diabetes and obesity.

“These findings may suggest a potential role for GLP-1 receptor agonists in the context of alcohol-use disorder.”

Source: The BMJ Group

Categories : DermatologyTags :

Blaming GLP-1 Medication for Hair Loss? You Might Be Asking the Wrong Question

On By ModernMedia
Photo by Towfiqu barbhuiya

Globally, more people are using GLP-1 and other weight-loss medicines, and some are experiencing severe hair loss while taking them. But just because it is happening during treatment does not necessarily mean the treatment caused it. According to Dr Kashmal Kalan, Medical Director at Alvi Armani, “Hair shedding during treatment isn’t always caused by the medicine itself. In many cases, it may be the body’s response to losing weight too quickly. Your body reacts as though food is scarce and thinks: ‘Hair isn’t essential. Let’s save energy’.”

Rapid weight loss can increase the risk of temporary hair shedding, whether it follows GLP-1 treatment, bariatric surgery, a very low-calorie diet, or illness. The trigger is often the speed and extent of the weight loss rather than the treatment itself. Eating much less can also leave patients short of nutrients that hair needs. “Think of hair like a houseplant. If you don’t water it enough with the right nutrients, it grows poorly. It doesn’t necessarily die permanently but simply pauses its growth.”

The concern is becoming more relevant as weight-loss medicine use grows in South Africa. Discovery Bank and Visa’s latest SpendTrend report found that 14% of surveyed higher-income South Africans use prescribed weight-management medication. Clinical research has also found that GLP-1 medicines reduced energy intake on a controlled test day by nearly a quarter compared with placebo, which helps explain why nutritional adequacy may become more important when appetite drops.

Dr Kalan says Alvi Armani is seeing more patients who report sudden hair shedding weeks or months after starting weight loss treatment and assume the medicine is directly responsible. The consultation must then establish when the shedding began, how quickly the patient lost weight, how their eating patterns changed, and whether another medical cause needs to be investigated.

The potential causes behind rapid hair loss

A review of nearly half a million adults on GLP-1 treatment found vitamin D deficiency in 7.5% of patients at six months, climbing to 13.6% by twelve months. That’s why bloodwork and not a shopping list of supplements is the first step in any hair loss consultation at Alvi Armani, whether GLP-1-related or not. Standard testing includes vitamin D, B12, ferritin, and thyroid function as standard.

“Ferritin, the protein that stores iron, is one marker I monitor closely. A level below 30 ng/mL, generally considered indicative of low iron stores in adults, is often enough to cause shedding on its own, even though most labs still call that number normal. Most of these patients feel completely fine elsewhere, so there’s no reason for a routine GP visit to pick it up. By the time the hair’s already falling out, we go back and look for what that visit potentially missed.”

Some patients may also reach for gut-health supplements because they assume hair loss comes from issues in the gut. However, Dr Kalan notes, probiotics will only address the problem if a digestive condition is actually contributing to it. Research remains limited, with the largest randomised trial to date finding reduced shedding among the probiotic group, but no meaningful improvement in hair density or thickness.

“If someone has a diagnosed digestive condition, that’s worth treating, and probiotics may have a place. Outside of that, I’d rather see patients pursue tests that can identify what’s missing than a supplement with no clear indication, strain, or dose.”

Dr Kalan encourages anyone on a GLP-1 medication to take shedding seriously if it continues past three months, worsens noticeably, or comes with fatigue or other symptoms that don’t add up. “These medications genuinely change lives for the right patient. If your registered health professional recommends continuation, stay on it. Just make sure your body is still getting what it needs.”

Categories : Metabolic DisordersTags :

Sun Pharma Launches Generic Semaglutide in South Africa

On By ModernMedia

Johannesburg, 21 July 2026 — Sun Pharmaceutical Industries Limited (Reuters: SUN.BO, Bloomberg: SUNP IN, NSE: SUNPHARMA, BSE: 524715) (together with its subsidiaries and/or associated companies, “Sun Pharma”) today announced the launch of generic semaglutide, a once‑weekly GLP‑1 receptor agonist, in South Africa for the treatment of adults with inadequately controlled type 2 diabetes mellitus as an adjunct to diet and exercise.

The product is supplied in a pre‑filled, multi‑dose injectable pen in two strengths (2 mg/1.5 mL and 4 mg/3 mL) that allow flexible, once‑weekly dosing. The device features a smooth dialer for accurate dose selection and a concealed needle to improve handling safety and reduce injection anxiety. The pens are manufactured in Europe and developed with established pharmaceutical device suppliers.

“Type 2 diabetes remains a major public‑health challenge in South Africa,” said Malcolm Brown, Chief Executive Officer, Sun Pharma South Africa. “The availability of generic semaglutide strengthens the range of evidence‑based treatment options available to clinicians and patients. Our objective is to support better clinical outcomes by improving access to proven therapies that can be integrated into comprehensive diabetes care.”

Clinical context and public‑health relevance

  • Type 2 Diabetes remains one of South Africa’s most significant public health challenges. As per the International Diabetes Federation country report, it is estimated that 3.9 million patients aged 20-79 would be living with diabetes in South Africa by 2050.
  • South Africa faces a growing burden of type 2 diabetes, driven in part by rapid urbanization and changing lifestyles. This rising prevalence places significant pressure on patients and healthcare services. Improving access to effective therapies is therefore an important component of addressing this national health challenge.
  • With the launch of generic semaglutide in South Africa, Sun Pharma aims to provide clinicians and patients with an additional licensed option for comprehensive diabetes management, supporting better long‑term outcomes when used alongside diet and exercise.

Regulatory and medical review

Healthcare professionals are advised to consult full prescribing information and local treatment guidelines when considering semaglutide for individual patients. The company’s local medical team is available to assist clinicians with scientific inquiries and product information.

About Sun Pharmaceutical Industries Limited. (CIN – L24230GJ1993PLC019050)

Sun Pharma is a leading global pharmaceutical company with a presence in Innovative Medicines, Generics and Consumer Healthcare products. It is the largest pharmaceutical company in India and is a leading generic company in the US as well as Global Emerging Markets. Sun’s high growth Global Innovative Medicines portfolio spans innovative products in dermatology, ophthalmology, and onco-dermatology and accounts for about 22% of company sales. The company’s vertically integrated operations deliver high-quality medicines, trusted by physicians and consumers in over 100 countries. Its manufacturing facilities are spread across five continents. Sun Pharma is proud of its multi-cultural workforce drawn from over 50 nations. “For further information, please visit www.sunpharma.com and follow us on LinkedIn & X (Formerly Twitter).”

Categories : Metabolic DisordersTags :

Most Obesity Drugs Do Not Improve Quality of Life or Heart Health

On By ModernMedia

Treatment decisions should be individualised, balancing expected benefits, harms, treatment burden, costs, availability, and patient preferences, say researchers

By HualinXMN – Own work, CC BY-SA 4.0

Despite substantial weight loss, most obesity drugs such as Wegovy and Mounjaro do not meaningfully improve quality of life and few show cardiovascular benefits at one year, finds an analysis of the latest evidence published by The BMJ today.

More weight loss is also generally accompanied by greater harms including stomach and bowel symptoms, fatigue, and loss of lean (muscle) mass – and improvements are not sustained after stopping treatment.

Several drugs for adults with overweight or obesity produce substantial weight loss, but most have not been compared directly in head-to-head trials, leaving uncertainty about the broader balance of benefits and harms.

To address this, researchers searched scientific databases for randomised controlled trials comparing one or more drugs with lifestyle changes, placebo, or another drug.

They found 262 eligible trials involving 99,791 participants (average age 49; 63% female; average BMI 35) that evaluated 19 currently available and emerging obesity drugs with follow-up from 12 to 172 weeks.

Benefits included changes in body weight, fat mass, and quality of life, while potential harms included changes in lean mass, gastrointestinal adverse events, gallbladder related disorders and fatigue.

The trials were of varying quality, but the researchers were able to assess the certainty of evidence using the recognised GRADE system.

Compared with lifestyle changes alone, the largest weight loss after one year was with tirzepatide (14.9%) and CagriSema (14.8%), followed by oral semaglutide (10.9%), orforglipron (9.9%), subcutaneous semaglutide (9.8%), and phentermine-topiramate (8.1%).

Emerging drugs – including retatrutide, ecnoglutide, and mazdutide – showed large effects on weight loss but are supported by low or very low certainty evidence.

Greater weight loss was consistently accompanied by higher rates of side effects and treatment discontinuation, which the authors say indicates a clear benefit-harm trade-off.

Tirzepatide reduced fat mass the most (by 25.7%) but also lean mass the most (8.3%). Subcutaneous semaglutide was the only drug associated with a reduced risk of death from any cause (19%), heart attack (28%), and heart failure (57%). Tirzepatide also reduced heart failure risk by 51%.

No drug convincingly reduced kidney failure or showed clinically important improvements in quality of life.

The authors acknowledge that most trials had relatively short follow-up, limiting conclusions about long term safety, quality of life, and effects on heart and kidney health. In addition, evidence for several newer drugs was sparse and of low certainty, and trial populations may not fully represent real world patients.

However, they say this review provides a comprehensive and up-to-date comparison of currently available and emerging obesity drugs across a broad set of outcomes important to patients, clinicians, and policymakers.

They conclude: “Treatment decisions for obesity should be individualised, balancing expected benefits, harms, treatment burden, costs, availability, and patient preferences.”

This study represents an important step in providing comparative information to inform patient-clinician discussions about obesity drugs in this rapidly evolving landscape of treatment options, say researchers in a linked editorial.

And they suggest future studies that incorporate individual characteristics, as well as long term outcomes, such as mortality, should provide additional data to inform individualised decision making.

Source: The BMJ Group

Categories : Ageing Metabolic DisordersTags :

Popular GLP-1 Drug May Slow Down Biological Aging

On By ModernMedia

By calming inflammation and reducing excess fat, semaglutide may postpone several molecular signs of aging, pointing to the potential of GLP‑1 receptor agonists to help prevent age‑related diseases.

Photo by Haberdoedas on Unsplash

Semaglutide slowed biological aging across multiple epigenetic clocks in a randomised, double-blind, placebo-controlled clinical trial. The strongest signals were seen in epigenetic measures linked to inflammation, brain, heart, blood, kidney, liver and metabolic health, suggesting that the drug may influence aging-related biology across multiple body systems. The findings offer early clinical evidence that GLP-1 receptor agonists may influence aging biology.

Glucagon-like peptide-1 (GLP-1) receptor agonist medications have gained widespread attention for effectively treating obesity, lowering blood sugar and decreasing the risk of cardiovascular disease. Some researchers have proposed that these drugs may also influence the biology of aging, but direct evidence in humans has remained limited. Now, a new study provides the first randomised, placebo-controlled clinical evidence that semaglutide, a widely used GLP-1 drug, slows down the accumulation of biological aging markers in the DNA of adults with HIV. The study is published in Nature Communications.

Researchers at the University of California San Diego and several partner institutions analysed data from a previously published clinical trial of 108 adults with HIV‑associated lipohypertrophy, a condition in which excess fat builds up around the abdomen. About half of the participants received weekly injections of semaglutide, with the rest receiving placebo injections.

The team used a set of biological “epigenetic clocks” to track cellular aging over the 32-week treatment period. These clocks detect DNA methylation, chemical marks on DNA that help regulate how genes are turned on or off without changing the genetic sequence itself. By measuring changes in these marks, the team could assess whether the treatment was associated with a slower or faster biological aging pattern.

People with HIV often experience accelerated aging, even if it is well-controlled with antiretroviral therapy, according to first author Michael Corley, PhD, associate professor at UC San Diego School of Medicine and the Stein Institute for Research on Aging. However, the study found compared to the placebo group:

  • Participants treated with semaglutide exhibited a broad pattern of slower biological aging across epigenetic clocks linked to inflammation and blood, brain, heart, kidney, liver and metabolic health.
  • The drug slowed the pace of biological aging by 9 %, as measured by the DunedinPACE epigenetic clock.
  • The drug significantly slowed biological processes associated with the risk of all‑cause mortality and age-related disease, as measured by the PCGrimAge epigenetic clock.

Research suggests there are several mechanisms by which semaglutide may influence biological aging. By reducing inflammation and metabolic stress, GLP-1 drugs decreased chronic immune activation, a primary driver of accelerated aging in people with HIV. They also reduce visceral and ectopic fat that accumulates around the abdomen and organs, which may help curb the inflammatory and metabolic signals that promote aging.

“Emerging data also suggest that GLP-1 drugs may reprogram certain cells in different organs, which could help explain why we see effects across multiple aging clocks,” said Corley.

While the study focused on people with HIV‑associated lipohypertrophy, Corley says it may also offer lessons for the wider population.

“Many of the biological processes we study in HIV are also central to aging in the general population,” he said. “Because these processes can emerge earlier or be more pronounced in people with HIV, this community can help us identify interventions that may improve healthspan more broadly.”

In a related pilot study published in npj Aging, Corley and another team of researchers found that taking semaglutide for 24 weeks:

  • Reduced the rate of biological aging for 42% of participants with HIV and metabolic dysfunction-associated steatotic liver disease (MASLD) as measured by the DunedinPACE epigenetic clock. Those participants also had a greater reduction in liver fat compared with participants whose pace of aging sped up.
  • Slowed aging associated with the risk of all‑cause mortality in 34% of participants as measured by the PCGrimAge epigenetic clock.
  • Increased the length of telomeres in nearly 49 % of participants as measured by the PCDNAmTL epigenetic clock. Those participants also tended to walk faster after treatment, suggesting better physical function.

Together, these studies add to growing evidence that GLP-1 drugs may influence pathways involved in biological aging.

“We are not saying that semaglutide reverses aging or makes people younger. What we are seeing is a signal that it may slow some of the biological processes associated with aging.”

— Michael Corley, PhD

“We are not saying that semaglutide reverses aging or makes people younger,” said Corley. “What we are seeing is a signal that it may slow some of the biological processes associated with aging. With newer GLP-1–based therapies now emerging, the field has an opportunity to test whether different drugs in this class have distinct effects on aging biology and to identify which patients may benefit most.”

Larger clinical trials are needed to confirm the findings, determine how long treatment effects last, and establish optimal dosing and treatment duration for both people with HIV and the broader population. Future studies will also be needed to test whether the effects of GLP-1 effects on aging biology are enhanced when combined with lifestyle interventions such as diet, exercise and sleep optimization.

The Stein Institute for Research on Aging plans to translate these results into individualized “aging dashboards” to track biological aging with epigenetic clocks, enabling clinicians to design personalised therapies that target the underlying mechanisms of aging and help prevent age‑related diseases.

By Susanne Clara Bard

Source: University of California San Diego