A new obesity drug, Wegovy, reduced the risk of serious heart problems by 20 percent in a large trial, the drugmaker said Tuesday, a finding that could challenge the understanding of the drugs. that weight loss as nothing more than cosmetic drugs and put pressure on insurers to cover them.
The trial is the first to show that the new class of obesity drugs can bring long-term heart health benefits for people who are overweight but don’t have diabetes.
With obesity affecting 100 million adults in the United States and accounting for nearly $150 billion in annual health care spending, new treatments could help address some of the most important and costly problems in American medicine.
The results “show the urgent need for patients living with obesity to be offered this effective and safe drug to prevent future disease,” said Simon Cork, an obesity expert at Anglia Ruskin University in England unrelated to medicine.
Many details were missing from Tuesday’s announcement by Wegovy’s maker, Novo Nordisk. The company said the drug reduced the overall risk of heart attacks, strokes and cardiovascular deaths by 20 percent. But it doesn’t isolate the drug’s effects on each of those outcomes.
The company also did not describe how much weight the patients lost or provide details on the drug’s side effects and how many patients decided to stop taking it. The data have not been published in a peer-reviewed journal; the company said it will present more detailed results at a scientific conference later this year.
However, the trial included nearly 18,000 adults with previous cardiovascular disease and followed them for up to five years. This reinforces the idea that obesity drugs can deliver long-term health benefits in addition to helping patients lose weight, experts said, undermining the argument that they are vanity only drugs that have minimal effects on patients’ underlying health.
That could prompt more insurers to pay for the drug, at least for patients who, like trial participants, already have evidence of heart disease.
“It’s going to be harder to deny coverage and not pay for these products for a population that doesn’t have diabetes,” said Craig Garthwaite, a health economist at Northwestern University’s Kellogg School of Management. “It would be very difficult to make the argument that this is not part of an important health benefit when there are cardiovascular benefits.”
Medicare does not cover weight loss drugs and some employer insurance plans refuse to pay for them, due to the perception that the drugs are not essential medical remedies. The drug’s high list price of $1,349 a month makes it unaffordable for most insurance won’t cover it.
Reducing the risk of heart attacks or strokes would not only save many Americans years of suffering and medical complications but also bring other economic benefits, restoring productivity losses from disease. on the heart and reducing spending on less effective obesity treatments, said Dr. Garthwaite.
However, he said, the benefits for patients’ heart health are far enough down the road that insurers themselves may not see direct cost savings. If other drugs from the new obesity treatment class also prove to reduce cardiovascular disease, he said, that could create competition between the products that eventually lowers their prices.
Wegovy is currently approved for chronic weight management in the United States. Novo Nordisk said it would ask regulators in the United States and Europe to clear the drug for additional medical indications as well, but did not say which ones.
Another version of the same drug made by Novo Nordisk, Ozempic, is approved for lowering blood sugar levels in adults with type 2 diabetes. A smaller trial found that Ozempic also reduced the risk of heart complications in diabetic patients.
Martin Holst Lange, the company’s executive vice president for development, said the latest trial showed the drug “has the potential to change how obesity is treated and treated.”
Scientists say it’s not exactly clear how the drug reduces people’s risk of heart complications.
The new class of obesity drugs has been shown to have some direct effects on blood vessels and the heart, including studies that found animals given the drugs survived better heart attack, said Dr. Daniel Drucker, a senior scientist at the Lunenfeld Tanenbaum Research Institute in Mt. Sinai Hospital in Toronto who helped identify the hormone that led to the new drugs and were paid consulting or speaking fees by Novo Nordisk.
But they may also indirectly lower the risk of heart disease by reducing body weight, blood pressure or inflammation.
This new class of obesity drugs “has two shots at goal to improve cardiovascular health,” he said.
Additional details from the new trial will allow researchers to study the relationship between how much weight the patients lost and their cardiovascular benefits, potentially making it clearer how the Wegovy the heart health of people.
“This is really the beginning of a new chapter in improving the health of people with obesity,” said Dr. Drucker.
However, he said the trial will also help researchers understand the range of side effects, especially given the size and duration of the study. Patients have reported nausea, diarrhea, vomiting, constipation and abdominal pain, and some have stopped taking the drug because of these effects.
Experts say the trial could also change an approach to obesity that has long emphasized patients’ responsibility for fighting their own weight gains.
“Obesity is not a personal choice — it’s not a behavior, it’s not something people choose,” said Dr. Ania Jastreboff, an endocrinologist and obesity-medicine specialist at Yale University who is an investigator in the Wegovy trial and consults for makers of obesity drugs. . “Drugs like this, we believe, have the potential to treat the underlying biology.”
The latest results, he said, “underscore the need to treat obesity as we treat any other disease.”
