The potential of semaglutide is only just beginning to be understood. (Image: Getty)
Taking a weight-loss drug could provide a “Fountain of Youth” tackling the underlying causes of a wide range of conditions, scientists have predicted. A raft of groundbreaking studies presented at the world’s largest cardiology conference on Friday provided fresh evidence of the drugs’ myriad health effects.
Research found they could provide a lifeline for previously untreatable high blood pressure, reverse progression of kidney disease, prevent heart failure and slash Covid deaths.
Yale University professor Dr Harlan Krumholz is editor-in-chief of the Journals of the American College of Cardiology, which published several of the papers presented. He said the “remarkable” drugs were poised to revolutionise heart care and could even slow biological ageing, allowing people to “live longer and better” lives.
The US expert added: “This is an anti-obesity medication but honestly you could just think about it as a health promotion medication, or in the case of these studies, heart medication.
“It’s a multi-purpose drug. The evidence does excite me. It’s an important inflection point in medicine to have a tool like this that can so promote health.”
READ MORE: Weight loss jabs not a quick fix to get beach-body ready, warns top NHS doc
Weight loss jabs containing semaglutide have been hailed as gamechanging (Image: Getty)
More than 30,000 heart doctors from across the globe gathered in London this week for the European Society of Cardiology’s (ESC) annual congress. Presentations on weight loss jabs containing semaglutide were among the most hotly anticipated.
The drugs belong to a class known as GLP-1 receptor agonists. Developed to treat type 2 diabetes, they are now showing promise against a variety of conditions including chronic kidney disease, Parkinson’s, and even cancer.
The way in which they work is not yet fully understood. There are obvious benefits linked to weight loss, however studies have shown that patients who do not lose a significant amount of weight can also see their health improve.
A leading theory is that the jabs reduce inflammation. Inflammation is a normal part of the body’s immune response to injury or infection but is believed to increase risk of many conditions, from arthritis and dementia to cancer and bowel disease.
One landmark study of 1,400 patients presented at the conference found that taking semaglutide dramatically cut levels of inflammation in the body, regardless of weight loss.
Dr Krumholz said: “We know that obesity itself can raise your levels of baseline inflammation in your body. I think of it like a thermostat – there are some people walking around who have higher levels of just baseline inflammation.
“These drugs are somehow quieting inflammation, there’s something going on with the immune system.”
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Chronic inflammation is also a hallmark of ageing. Asked whether the drugs could help turn back a person’s biological clock, Dr Krumholz said: “Is it a Fountain of Youth?
“I would say if you’re improving someone’s cardiometabolic health substantially, then you are putting them in a position to live longer and better.
“There are measures of how fast we’re biologically ageing and it wouldn’t surprise me that improving people’s health this way actually slows down the ageing process.”
Earlier this year, experts suggested weight loss jabs could be as transformational as statins for heart care, after a trial showed they cut risk of dying from a heart attack or stroke by a fifth for patients who were overweight or obese.
Latest research from the ESC congress revealed the drugs could also strengthen people’s ability to fight off infectious diseases.
A trial involving 17,000 patients found those who were taking semaglutide before the pandemic and caught Covid were 34 percent less likely to die, compared to those not taking it.
Study leader Dr Jeremy Samuel Faust, of Harvard Medical School, said the effect was “akin to a vaccine” and could apply to many other infections.
Dr Krumholz added: “We already knew that the people at greatest risk during the pandemic were people who had diabetes, people who had obesity, people who had metabolic disorders.
“But I don’t think we might have dreamed that actually treating the obesity would reduce the risk from the virus.”
In another study of over 100 people with treatment-resistant blood pressure, 26 percent of those who took semaglutide were able to come off or reduce their dose of other blood pressure drugs.
Researcher Dr Cormac Kennedy, from Trinity College Dublin, said: “Semaglutide has worked where other medications have failed.
“Patients with resistant hypertension are on three, four, five medications. These are high-risk people who have heart attacks and strokes. They’re very difficult to treat.”
And in a further study of over 3,000 chronic kidney disease patients, those who received weekly semaglutide injections saw their risk of dying from heart attacks or strokes cut by 29 percent over three years.
For many conditions linked to obesity, semaglutide-based medicines are a treatment option that can tackle the root causes rather than simply combating the consequences, Dr Krumholz added.
“I think what’s going to happen is, if I’m seeing a patient in clinic who has hypertension [high blood pressure] and obesity, the first thing I should do is treat their obesity, because I may not have to treat the hypertension anymore, it may go away.
“I think we’re going to have a choice. You can either treat the manifestations of obesity, or you go straight to treating obesity. And it may be that we think we’re treating obesity but these meds are actually working in other ways too.”
Weight loss jabs such as Wegovy are currently available on the NHS to patients who have a BMI over 30 (obese) or over 27 (overweight) with weight-related health conditions, while Ozempic is only licensed to treat diabetes.
The Yale professor predicted that the drugs will be available in pill form within a few years, and suggested their success raises questions about whether their use should be extended.
He added: “The fact that the benefit spans different levels of weight loss throws into question whether or not these drugs should be reserved for people with the most severe forms of obesity. It’s going to have the potential to really improve population health.”
Leading British cardiologist Professor John Deanfield, of University College London, said it was “very exciting” to think that these drugs could “alter the evolution and the consequences of multiple diseases”.
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He added: “We’re waiting to see what it does to dementia and other diseases. These are the diseases of aging we’d all like to avoid.
“They stop being weight loss drugs, with all of the controversy about lifestyle drugs, and they become drugs that will target diseases, a different category. It’s incredibly exciting.”
Consultant cardiologist Dr Sonya Babu-Narayan, associate medical director at the British Heart Foundation, described the drugs as a “game changer”.
She said: “Cardiovascular disease remains the world’s biggest killer. It’s always a cause for celebration when an effective new treatment is found.
“Studies show semaglutide can not only lead to substantial weight loss, but is also effective to save and improve lives for people living with heart disease.
“New research is helping to unravel the different mechanisms of action behind the cardiovascular benefits seen – from weight loss itself, to improvements in metabolic and inflammatory regulation or fat distribution. This could be a gamechanger for patients with a range of different heart conditions.”
These drugs are not just anti-obesity agents, says DR NEHA PAGIDIPATI
Weight loss obviously caused a lot of excitement but people didn’t necessarily realise the tremendous benefits these drugs could also have for heart and kidney health.
What is becoming increasingly clear is that even if an individual does not lose as much weight as they had expected or hoped to, that doesn’t necessarily mean they won’t get the important health benefits, including for the cardiovascular system and kidneys.
I don’t like to call these drugs ‘weight loss’ agents. Obesity is a disease process that is not just the ‘fault’ of the patient, so I prefer to call them anti-obesity agents.
However, it’s becoming increasingly clear that calling semaglutide an anti-obesity agent understates its true potential. I would call it a cardiovascular and kidney risk-reduction agent.
We are just at the beginning of our understanding of these drugs. There are dozens of similar agents in the pipeline and dozens of trials happening.
There’s no question to me that this is the beginning of a new era.
Many people don’t just have one problem – they might have many issues that often run together, such as diabetes, obesity, heart failure, coronary artery disease, kidney disease, and so forth.
Drugs that can address all of those things at once are really the next frontier of medicine.
Still to this day, heart disease is the number one killer of people around the world.
This is an exciting time and as we find more medicines that will help, it’s important that they reach the people who need them most.
– Dr Neha Pagidipati is JACC associate editor and cardiometabolic disease specialist at the Duke Clinical Research Institute
