Glucagon-like peptide-1 (GLP-1) drugs have made an impact on the market and culture at large at a scale rarely seen since the introduction of the birth control pill. Like the pill, GLP-1 drugs are not only changing personal health decisions, but sparking society-wide conversations around body image, equity, and access to care.
Whereas the birth control pill transformed the economy by expanding the participation of women in the workforce, GLP-1 drugs have had wide-ranging—if somewhat less profound—effects on the food industry, pharmacies, medical devices manufacturers, and the stock market. They’ve even become the flagship offering of pharmaceutical developers entering the direct-to-consumer space.
But while the pill is now mainstream enough that the broader conversation has quieted (just wait until the male contraceptive pill clears clinical trials), GLP-1 drugs continue to make news nearly every day.
From the latest advancements to novel applications to newfound risks, here’s a roundup of the need-to-know developments in GLP-1 agonists.
Ongoing research refines understanding of GLP-1 drugs
Emerging research is deepening the medical community’s understanding of GLP-1 drugs, revealing potential benefits, health effects, and interactions with other compounds.
A recent study from the UNC School of Medicine found that an oral version of semaglutide—sold in injectable form as Wegovy and Ozempic—can reduce the risk of cardiovascular events like heart attack and stroke by 14% in people with type 2 diabetes, atherosclerotic heart disease, or chronic kidney disease.
Not only does this development offer good news for patients who prefer pills to injections, it also supports the growing body of evidence showing that GLP-1 agonists have applications beyond glycemic and weight control.
But not all news is positive in the world of oral GLP-1 drugs. Pfizer decided to scrap its trial of danuglipron, an experimental oral GLP-1 agonist, after the once-daily drug caused liver injury in a phase 3 trial participant. Thankfully, the participant recovered after stopping usage of the drug, but the outcome is still a blow to the pharmaceutical giant, which had previously discontinued development of another oral GLP-1 drug in 2023 after a patient suffered similar injuries.
For patients concerned about losing lean muscle mass while using semaglutide or tirzepatide, however, there is some good news: A new study conducted by obesity specialists in New York found that incorporating resistance training, increasing protein intake, and reducing the speed of weight loss can mitigate the risk of GLP-1-associated muscle loss.
Expanded use cases bring GLP-1 to unexpected therapy areas
Originally created to help patients with type 2 diabetes manage their blood sugar, GLP-1 receptor agonists rose to fame after providers began prescribing them off-label for weight loss. Now that the drugs have been formally approved to treat obesity, they’re spreading even further into new areas of medicine.
Research published in Nature Biotechnology found that GLP-1 drugs show promise in treating addictive behaviors related to nicotine, alcohol, and opioids. Researchers believe GLP-1 receptor agonists may modulate dopamine pathways, diminishing the reward response that drives most forms of addiction.
That’s not the only way these drugs interact with the brain. Two papers published in JAMA Neurology suggest that GLP-1 receptor agonists could have a neuroprotective effect, reducing the risk of dementia by up to 50%. While randomized trials are needed to draw any definitive conclusions, these findings could revolutionize a field that has been riddled with setbacks—from controversial drug trial failures to the dissolution of leading causal theories—in just the past few years.
GLP-1 could also have unexpected applications in the treatment of lymphedema, a buildup of lymph fluid that causes swelling in many patients receiving cancer treatment, according to a study published in Frontiers in Oncology. The study found that GLP-1 therapy reduced inflammation and fluid retention in a patient receiving chemotherapy. While the study only examines a single patient, it offers at least a glimpse of relief for others living with a condition that currently has no known cure.
New risks emerge for certain patients
As GLP-1 drugs become more widely used across therapy areas, new risks are emerging, too.
A study published in Nature Medicine used data from 2.4 million participants to create an “atlas” of the benefits and risks of GLP-1 drugs in comparison to other commonly used antihyperglycemic drugs like sulfonylureas, dipeptidyl peptidase 4 (DPP4), and sodium-glucose cotransporter-2 (SGLT2) inhibitors.
While the study showed that GLP-1 agonists are associated with decreased risks of certain severe health outcomes like pneumonia, suicidal ideation, and alcohol use disorder, they may increase the risk of other outcomes, including gastroesophageal reflux disease, nausea/vomiting, and sleep disturbances.
These risks may be especially pronounced for people taking GLP-1 drugs to treat type 1 diabetes, a group that has grown considerably over the last decade despite a lack of evidence for the compound’s safety or efficacy among this cohort. In fact, the labels for Ozempic and Mounjaro specifically advise against their use for type 1 diabetes.
The Diabetes, Obesity, and Metabolism study that identified the rise in off-label use noted that GLP-1 therapies could cause people with type 1 diabetes to experience unpredictable blood sugar levels, nausea, and even diabetic ketoacidosis.
As demand for the drug skyrockets—among users intended and otherwise—one new risk is fairly unsurprising: counterfeit versions of Ozempic have found their way into the U.S. supply chain. The U.S. Food and Drug Administration has warned that these fakes could contain unsafe ingredients and is advising patients and doctors to check their prescriptions for specific lot and serial numbers. Ozempic developer Novo Nordisk is joining the FDA in testing the counterfeit supply to determine any specific health risks to patients who may have inadvertently taken the unauthorized drug.
Learn more
The potential of GLP-1 receptor agonists is immense, and new insights, applications, and risks are emerging all the time. Until this drug class reaches the ubiquity of ibuprofen, insulin, or the common birth control pill, you can count on us to keep covering it.
If you’re working in the provider or biopharmaceutical industries, you owe it to yourself (and your team, clients, and patients) to keep up with the latest developments in this exciting space. But you can do more than repeatedly refresh our blog feed to stay informed.
Sign up for a free trial today, and see how Definitive Healthcare’s data and analytics can help you track the most impactful trends in your market, from GLP-1 prescription patterns to patient behaviors and beyond.
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