India could soon allow ‘game-changing’ weight-loss drugs – Tirzepatide

Subject: Science and tech

Sec: Health

Context:

India approves 2 weight loss drugs — Mounjaro and Zepbound, and soon allow ‘game-changing’ weight-loss drug tirzepatide.

More about news:

Indians can now avail the blockbuster weight loss and diabetes drug Tirzepatide — marketed as Mounjaro and Zepbound in the US and made by Eli Lilly.
The final approval is expected to come from the Drug-Controller General of India based on this recommendation.
Indians will be able to access injectables of this class of drugs for the first time, bringing hope to those battling diabetes and obesity issues.
These can reduce your body weight by up to 18 per cent.
The oral version of a weight loss drug made by Eli Lilly’s Danish competitor Novo Nordisk –Semaglutide — has been approved and is available in India for diabetes management, its higher dose, injectable version meant for weight-loss isn’t.
Mounjaro addresses diabetes more while Zepbound targets weight loss.

Why experts cleared the drugs?

The committee has approved the import of single dose vials and pre-filled pens of the injectable drug in six different doses, ranging from 5 mg to 12.5 mg.
This nod is based on two global clinical trials, which also included a significant number of Indians.
In a trial of adults without type 2 diabetes, those on the highest dose of Tirzepatide lost an average of 18 per cent of their body weight in 72 weeks.
In a trial among those with diabetes, participants lost an average of 12 per cent of their body weight.

Why Tirzepatide has an edge over semaglutide:

Semaglutide belongs to a class of drugs called GLP-1 receptor agonists, which lower serum glucose levels.
Tirzepatide mimics both the GLP-1 hormone and the GIP hormone.
The latter can trigger insulin creation and sensations of fullness, thereby increasing the chances of weight loss.

Who can use the drugs?

The patients should also be asked to follow a diet and exercise
The drug should be prescribed only when they are able to maintain the same weight level or bring it down by adhering to it.

Who should not use these drugs?

Side effects:

High risk:

Thyroid tumours
Lump or swelling in the neck
Hoarseness
Trouble swallowing
Shortness of breath
Individuals cannot use Zepbound if they, or any family members, have ever had medullary thyroid carcinoma (MTC), a type of thyroid cancer, or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), a rare inherited disorder that affects the endocrine glands.

Are the drugs effective?

Dosage should follow only after the patient has done lifestyle modifications and is still hovering around the body mass index (BMI) of 30.
These drugs may help knock off the weight initially but to sustain the weight loss.
They do not work the same way for all.

Affordability:

Are Zepbound and Mounjaro the same?

Mounjaro and Zepbound are once-weekly injections that contain the same active ingredient:
Both brand names share similar dosages, side effects, and drug interactions.
Mounjaro is FDA approved for Type 2 diabetes in
Zepbound is approved for chronic weight management in adults

Semaglutide vs tirzepatide:

The FDA has approved Wegovy (semaglutide) and Zepbound (tirzepatide) for chronic weight management in adults.
These drugs can be prescribed to those who are obese (with a body mass index of over 30), or overweight (with a BMI between 27 and 30), and have at least one other health condition related to their weight (such as high blood pressure, high cholesterol, or type 2 diabetes).
Semaglutide and tirzepatide are polypeptides, small proteins that boost the levels of naturally-occurring hormones in the body, including that of glucagon-like-peptide 1 (GLP-1), which control weight through the brain and digestive tract.
Higher GLP-1 levels, released in the gut, spark a reaction by stimulating neurons that alter gut function, leading to a sense of fullness.
This process also taps into a brain mechanism that lights up neural pathways, triggering the sensation of satiety – the feeling of being satisfied and having had enough to eat.
They also help manage glucose levels, making them an effective treatment for diabetes.
Semaglutide only targets GLP-1 receptors. On the other hand, tirzepatide also boosts a second hormone: glucose-dependent insulinotropic polypeptide (GIP).
The GIP also regulates weight through receptors in brain and fat cells.