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

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?

• History of pancreatic diseases
• Disorders of the endocrine systems
• Nausea
• Vomiting

Side effects:

• Nausea
• Diarrhoea
• Vomiting
• Constipation
• Abdominal pain
• Indigestion
• Injection-site reactions
• Fatigue
• Allergic reactions
• Hair loss
• Heartburn

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:

• These are expected to cost around Rs 15,000 a month.
• Long-term use would be a drain on the resources.

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.