Fortune: 'Weight loss miracle drug' semaglutide can reduce the risk of 42 health conditions

Reduce the risk of dozens of diseases

This study involved nearly 2 million patients and is the largest scale study to date on this type of glucagon like peptide-1 receptor agonist. The median follow-up time of all participants was about three and a half years, and they all had type 2 diabetes. About 215000 people use GLP-1, and the rest take various other diabetes drugs.

Although Ozempic and Wegovy dominate the US market with semaglutide, Al Aly and his team have included all GLP-1 drugs in their research scope. They evaluated the impact of these drugs on a comprehensive catalog of 175 health outcomes and found that compared to conventional care (where people continue to use conventional drugs instead of GLP-1 drugs), the use of GLP-1 was associated with a reduced risk of 42 outcomes (24%) and an increased risk of 19 outcomes (11%).

Some results are not surprising. In addition to blood sugar control and weight loss, it is expected to reduce the risk of stroke, heart attack, major heart events and kidney disease, because some GLP-1 drugs have been proven in clinical trials to help reduce the incidence rate of these diseases in patients with type 2 diabetes. However, compared to the usual treatment that patients receive (i.e. treatment without GLP-1), Al Aly is particularly surprised by the significant neurological effects of these drugs.

GLP-1 clearly has some neurotrophic effects, and in a sense, these drugs actually reduce the risk of quite a few neurological diseases, "the researchers said. For example, in the category of substance use disorders, the risks of alcohol, marijuana, stimulants, and opioid drugs have all been reduced.

GLP-1 may inhibit the center responsible for cravings in the brain - a mechanism that also helps with weight loss, Al Aly said. Similarly, a study published last year showed that compared with patients taking other anti diabetes drugs, patients taking smeglutide had significantly lower risk of seeking medical care or consultation due to smoking.

Weight loss and reduction of inflammation

Like any research, this study also has limitations. The data comes from the VA database, which mainly focuses on males, white people, and the elderly. The scale of this study may to some extent weaken this impact. Al Aly suggests that for so many health outcomes, this test may miss some weaker signals that can be detected through narrower studies with similar sample sizes.

In Al Aly's Nature Medicine study, GLP-1 also reduced the risk of respiratory failure, sepsis, chronic obstructive pulmonary disease, and pneumonia. A previous review of 28 randomized controlled trials showed that GLP-1 reduced the incidence rate of respiratory diseases.

The Future of GLP-1

According to the research of Kaiser Family Foundation, about one eighth of adults in the United States have taken GLP-1 medicine to treat diabetes, promote weight loss or prevent heart attack or stroke (people with a history of heart disease). But nearly 60% of people stop taking the medication within 12 weeks, and the time they have taken the medication is not enough to effectively evaluate its therapeutic effect on the condition.

There are many possible explanations for this, including side effects and drug costs. According to KFF's analysis, the list price of GLP-1 drugs ranges from $936 to $1349, excluding insurance, manufacturer coupons, or rebates. Due to the fact that the patients receiving GLP-1 treatment in the Al Aly study were all veterans with full drug insurance, their retention rate was higher - about 70% after one year.