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NEW YORK, Dec. 15 (UPI) -- Even in a year that saw new drugs for troubling conditions such as Alzheimer's disease and cancer greenlighted for use in the United States, medications for weight loss garnered a bulk of the health-related headlines in 2023. Other key drugs approved in the last several months are intended to treat hot flashes and postpartum depression. But drugs for overweight people have taken center stage.
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Most recently, in November, the Food and Drug Administration approved tirzepatide, sold as Zepbound, to treat obesity. It has the same active ingredient as Mounjaro, which was approved to treat diabetes -- even though some doctors prescribed it "off-label" for weight reduction.
The agency is expected to clear a similar drug, retatrutide, for the same purpose in early 2024, according to industry observers.
This means three repurposed diabetes drugs will have been approved to treatment obesity available nationally. Semaglutide, or Wegovy, was cleared in 2021.
Given the health benefits associated with weight loss for people who are overweight or obese, these drugs have "revolutionized the treatment" of these all-too-common disorders, endocrinologist Dr. Carolina Solis-Herrera told UPI in a phone interview.
All three are designed to lower blood sugar, or A1c, which in turn helps control body weight, and are administered via injection, she said.
"These medications really help our patients, particularly those for whom maintaining a healthy weight is a lifelong struggle," said Solis-Herrera, an associate professor and chief of the Endocrinology Division at The University of Texas Health Science Center at San Antonio.
A big problem
One reason these drugs have generated headlines is the prevalence of obesity in the United States -- the condition affects more than 40% of adults nationally, according to the Centers for Disease Control and Prevention.
In addition, Type 2 diabetes affects up to 30 million people in the United States and has been linked with increased risk heart disease, stroke and other health complications, according to the CDC.
Nearly half of all adults nationally have prediabetes, or elevated blood sugar, that places them at high risk for full-blown diabetes, Solis-Herrera said, noting that up to 70% of people with prediabetes develop Type 2 diabetes.
Obesity also places people at higher risk for Type 2 diabetes, and both conditions have been linked with heart disease, according to the CDC.
As a result, obesity and Type 2 diabetes can have significant negative impacts on people's lifespans, productivity and quality of life, because they both have "multiple complications," with obesity logging more than 200 alone, Dr. Solis-Herrera said.
"These are both chronic diseases that need long-term treatment," she said.
Given how common these two conditions are, additional treatments are needed, she added.
For example, the older drug semaglutide, or Wegovy, was in short supply for a while because of supply-chain issues related to the device used to inject it, Solis-Herrera said.
Although that's changed in recent months, FDA approving of Zepbound was "noteworthy" because it "is expected to increase competition among the new class of weight loss drugs, which could potentially reduce costs for payers and patients," Jonathan S. Levin, a policy researcher with think tank RAND Corp., told UPI in an email.
Zepbound injections cost more than $1,000 each without insurance, or about $300 less than Wegovy, according to industry reports.
"The entry of Zepbound could help increase the supply to meet the demand for these weight loss medications," said Levin, who researches drug industry trends.
Overshadowing others
Still, as notable as the introduction of these drugs has been in the healthcare industry, they are far from the only treatments that have made a significant impact.
In 2023, lecanemab-irmb, or Leqembi, for Alzheimer's disease; bexagliflozin, or Brenzavvy, for diabetes; fezolinetant, or Veozah, for hot flashes caused by menopause; and zuranolone, or Zurzuvae, for postpartum depression were among the more than 50 products cleared for use by the FDA.
In November, meanwhile, two new chemotherapies -- fruquintinib, or Fruzaqla, for colorectal cancer, and capivasertib, or Truqap, for some forms of breast cancer -- were approved and are expected to improve the prognosis for patients who have those forms of the disease, experts say.
And 2024 should also see key drug approvals in other diseases, industry observers say.
Industry observers expect the FDA to approve resmetirom, a drug designed to treat nonalcoholic steatohepatitis, or NASH, a leading cause of cirrhosis, according to the Liver Foundation.
NASH affects up to 5% of adults in the United States, and causes cirrhosis, a disease that results in severe liver damage, in about one in four of them, it estimates.
The liver plays a key role in digestion, the foundation says.
"One of the key disease areas we're closely watching is NASH," Pete Lyons, vice chair and U.S. life sciences leader at financial services firm Deloitte Consulting, told UPI in an email. "We see significant unmet needs," he said.
Another less common condition that could see a new treatment reach the market next year is schizophrenia, a chronic and severe mental health disorder that affects a person's perception of reality, social interactions and thought processes, according to the National Institute of Mental Health.
More approvals in 2024
KarXT, which combines xanomeline, a drug designed to treat brain disorders, and trospium, a treatment previously used for overactive bladder, is expected to be greenlighted by the FDA in the second half of 2024.
About 1.5 million people in the United States are diagnosed with schizophrenia each year, the National Institute of Mental Health estimates.
KarXT is specifically designed to treat schizophrenia and psychosis related to Alzheimer's disease, RAND's Levin said.
"Schizophrenia is another disease area where we see significant unmet needs and the potential to address those in the coming year," Lyons added.
Although Lyons wouldn't discuss specific drugs by brand, he added that schizophrenia treatments that, like KarXT, don't act on dopamine are potentially significant because they may have "reduced side effects and enhanced efficacy."
Dopamine is a neurotransmitter and hormone involved in mood and motivation, according to the Cleveland Clinic.
If approved in 2024, a drug like KarXT "could be the first new pharmacological approach to treating [schizophrenia] in several decades," Lyons said.
And yet, as important as these treatments will be for the people who suffer from conditions like NASH and schizophrenia, they are unlikely to have the impact of the diabetes and weight-loss drugs, experts said.
"So many people are affected by diabetes and obesity, and these diseases have so many health complications, Solis-Herrera said.
"We all want to go to the gym more, and eat better, and diet and exercise remain the cornerstone of weight management treatment, but you can only eat cardboard for so long before you stop," she added.
That's why, according to Solis-Herrera, these drugs "will change so many lives for the better."
