Introduction
If you thought semaglutide was the miracle drug of the decade, then you might change your mind soon. New weight loss drug amycretin has so far been showing greater efficacy than Wegovy in early trials.
On March 7, 2024, Danish company Novo Nordisk shared clinical trial results for the new obesity drug called amycretin. Participants lost as much as 13 percent of their weight over 12 weeks, notably higher than that of Wegovy. With Wegovy, patients shed 6 percent of their weight, also over 12 weeks.
What is amycretin and what do we know so far about it? This article explores the available information and future expectations.
Amycretin and how it works
Before we dive into what amycretin is, we must cover two hormones it taps into: GLP-1 (glucagon-like peptide-1) and amylin.
In our gut is the hormone GLP-1, and in our pancreas is another hormone, amylin.
Whenever we eat and blood sugar levels shoot up, GLP-1 triggers insulin release, bringing blood glucose levels down. It also delays gastric emptying, or that process wherein the food we eat exits the gut and enters the small intestine. Because it slows down digestion, it helps you feel fuller for longer.
Amylin, on the other hand, works hand-in-hand with insulin to regulate blood sugar levels. Similar to insulin, the pancreas secretes it to help regulate blood sugar levels. Like GLP-1, it plays a role in influencing food’s movement through the stomach and intestines. In addition, it also controls the rate at which glucose enters the bloodstream, thereby suppressing appetite.
The amycretin-semaglutide link
If you’re familiar with Ozempic and Wegovy, you know that its active ingredient, semaglutide, is a GLP-1 receptor agonist. GLP-1 Ras mimic how GLP-1 works, prompting insulin release when blood sugar levels are high, and delaying gastric emptying. Because people on semaglutide feel fuller for longer, then they don’t eat as much and as a result, lose weight.
Amycretin, on the other hand, is an amylin analog. It’s a chemical compound that possesses a similar structure and chemical properties as amylin. Like semaglutide, it’s a doppelganger of amylin, triggering insulin release in response to high blood sugar levels and controlling appetite.
What’s great about amycretin is that it stimulates both GLP-1 receptors in the gut and amylin receptors in the pancreas.
Taking amycretin
Now that we know what amycretin is and how it works, we can learn how you should take it. Amycretin is an oral treatment, meaning it comes in pill format and you must take it orally.
Just like Wegovy, you must take it daily to promote optimal weight loss effects. The oral format and daily administration may make it an even more desirable option than Wegovy. With Wegovy, patients have to administer it once weekly subcutaneously, or inject it under the skin.
Novo Nordisk is also testing a subcutaneous version of amycretin, the results of which will be available by 2025.
Eligibility
Amycretin is for those suffering from obesity and weight loss problems. However, Novo Nordisk has yet to share guidelines on the eligibility of individuals to take the drug.
Safety and efficacy
Research is still ongoing to uncover amycretin’s potential side effects and complications, as it undergoes early clinical trials. However, Novo Nordisk has noted that its safety and side effect profile will align with that of GLP-1. These primarily include gastrointestinal issues such as nausea, vomiting, diarrhea, constipation, heartburn, and abdominal pain.
Martin Holst Lange, Novo Nordisk’s head of development, reported that 80 percent of participants in amycretin’s trials remained on the drug. The positive retention rate is a good indication of the product’s safety and efficacy thus far.
The data from amycretin’s initial clinical trial won’t be readily available until around 2025. Phase 2 trials, meanwhile, are expected to commence beginning in the second half of 2024.
Availability of amycretin
It’s difficult to say when exactly amycretin will be available on the market, as it still undergoing clinical trials. The information from Phase 2 trials won’t be out until around 2026, at the earliest. The U.S. FDA is strict when it comes to approving new medicines, requiring thorough safety and efficacy information.
Despite the long wait, amycretin has already sent Novo Nordisk’s valuation to record highs. Its shares skyrocketed in early March 2024 following its announcement of the drug’s promising efficacy results. This made the drugmaker more valuable than Elon Musk’s automotive company, Tesla. Novo Nordisk’s stocks soared by nine percent and its market valuation was up to almost $610 billion.
Apart from amycretin, Novo Nordisk has also been developing CagriSema, a once-weekly subcutaneous treatment using amylin analog cagrilintide and semaglutide. The drug has already shown 17.1 percent weight loss in its phase 1 trial. Meanwhile, semaglutide users lost 9.8 percent of their weight phase 1 trial results.
Experts believe the obesity drug market will be worth $100 billion by 2030. It will likely remain lucrative for years, with Novo Nordisk and Eli Lilly maintaining a place at the top.
Though the future currently looks bright for amycretin, results of later trials won’t be as satisfactory as its earlier trials. Only about 10 percent of proposed drugs are successfully approved by regulatory bodies. Note that Novo Nordisk has not yet published its data on amycretin in a peer-reviewed journal. Also, it has also not been tested in a direct comparison trial.
The current market scenario
Novo Nordisk’s Ozempic and Wegovy aren’t the only brands shaking up the weight loss drug market. Pharmaceutical company Eli Lilly is behind fellow blockbuster weight loss drugs Mounjaro and Zepbound—made with tirzepatide—both of which use GLP-1.
Although Novo Nordisk and Eli Lilly enjoy a lion’s share of the obesity drug market, there are new competitors. Startup company Viking Therapeutics is a U.S. biotech company that develops treatments for endocrine and metabolic disorders.
Currently, Viking Therapeutics has three experimental compounds undergoing clinical trials. Specifically, these target conditions like obesity, fatty liver, and others that affect the nervous system and adrenal glands. Adrenal glands help regulate the heart rate, blood pressure, and other important bodily functions.
One of its GLP-1 drugs, VK2735, has helped participants lose 15 percent of body weight after 13 weeks of injections. This is even more than the placebo results of tirzepatide and semaglutide.
At the moment, another player, Danish biotech company Zealand Pharma, has been developing amylin analogs. In October 2023, the company presented the initial results of its amylin clinical trials. Low doses of amylin analog ZP8396 helped reduce body weight up to 5.3 percent in healthy and overweight participants.
Researchers found that ZP8396 with GLP-1 or GIP was more successful for weight loss versus using GLP-1 or GIP alone. GIP stands for glucose-dependent insulinotropic polypeptide. Similar to GLP-1, it stimulates the pancreas to release insulin when your blood sugar levels are elevated. In addition, it also delays gastric emptying. At the same time, it also decreases the amount of sugar produced by your liver.
A secondary trial is underway, which will look into the safety and efficacy of ZP8396 at higher doses. Viking Therapeutics has announced it will share results of the drug at medical conferences, although no dates have been confirmed.
The link to heart benefits
Semaglutide had an overall positive impact on the cardiovascular health ofobese or overweight patients with heart problems. This included reducing heart symptoms such as fatigue, shortness of breath, and swelling.
The study involved 500 participants in 13 countries who received semaglutide every week. Apart from the marked improvement in the heart symptoms, they also saw improvements in participants’ physical abilities.
Based on trial results, researchers found obese or overweight patients may have better quality of life through semaglutide use. The drug led to weight loss by 14.9%, with reductions in cardiovascular risk factors like blood pressure and cholesterol.
Since amycretin is partly GLP-1, it should also be able to display the same heart benefits for individuals. It should be noted, though, that weight gain is typical once the patient stops taking GLP-1 medications.
Supply issues
The world has been plagued with a massive shortage issue for several months now. Semaglutide’s overwhelming popularity led to a major supply issue in the latter part of 2023, affecting Ozempic and Wegovy. This shortage is likely to continue while the demand for the weight loss drugs remains high.
Semaglutide manufacturer Novo Nordisk admitted a “short-term stock-out” of Wegovy in America through December due to demand surpassing supply capacities.
Currently, semaglutide is sold in the following: Australia, Belgium, Canada, France, Germany, Japan, Netherlands, Switzerland, the US, and the UK.
The shortage problem will likely persist for several more years. However, Wall Street predicts the demand will slow down in 2024 with more treatments becoming available in the market.
As of January 2024, pharmaceutical companies have been increasing the prices of their medications, including Ozempic. Its price has risen by 3.5 percent for a month’s supply.
As consumers grapple with the shortage, healthcare providers have been turning to alternatives to treat type 2 diabetes and obesity. These include Trulicity (dulaglutide), Victoza (liraglutide), Bydureon (exenatide), Rybelsus (semaglutide), Adlyxin (lixisenatide), and Byetta (exenatide).
Over 650 million people are suffering from obesity worldwide, and around 480 million, meanwhile, have type 2 diabetes.
Conclusion
Novo Nordisk’s new obesity drug, amycretin, may be even more effective than its hit weight loss drugs Ozempic and Wegovy. This is based on the results from its preliminary clinical trials.
Over 12 weeks, participants lost 13 percent of their body weight, significantly higher than that of Wegovy. Amycretin targets GLP-1 receptors in the gut and amylin receptors in the pancreas, regulating blood sugar levels and suppressing appetite.
Though promising, it will take time to determine amycretin’s safety and efficacy, with stringent regulatory bodies like the US FDA. Other market players are testing their own amylin analogs and other experimental weight loss drugs.
Analysts foresee that the weight loss drug market could be valued at $100 billion by the end of the decade.
< Image by Freepik
