Semaglutide drugs may help a lot more than diabetes and obesity

I have, in the recent past, disparaged the apparently ubiquitous semaglutide drugs like Ozempic and Wegovy, although mainly because of their tedious blanket advertising.

However, more and more evidence is coming to light showing that these drugs - technically called GLP-1 agonists, for their ability to mimic the action of the naturally occurring GLP-1 hormone - may be helpful in treating many more conditions than diabetes and obesity.

Drugs like semaglutide, and the similar tirzepatide, lyraglutide and lixisenatide, act on GLP-1 receptors in the pancreas to trigger the release of insulin after eating, which helps control blood sugar levels in people with diabetes. They also bind to GLP-1 receptors in the brain, which has the effect of making people feel full, and so eating less. 

But, unexpectedly, it turns out that there are also GLP-1 receptors in cells in other organs of the body too, including the heart, blood vessels, liver and kidneys. Thus, they can help prevent serious heart problems like heart attack, heart failure and stroke, partly by reducing the contributory obesity problem, but partly by acting directly on the heart's cells. Wegovy has already been approved in the USA for people with cardiovascular disease. It lowers blood pressure, cholesterol levels, heart rate and heart inflammation, and seems to be effective regardless of how much weight is lost.

Research is also showing that GLP-1 agonists can significantly reduce kidney disease. They may even reduce inflammation in the brain, raising hopes that they could be used to treat conditions like dementia and Parkinson's disease. They appear to slow substantially the shrinkage over time of the parts of the brain that control memory, learning, language and decision-making, resulting in reduced cognitive decline. They have also been shown to slow the progression of Parkinson's symptoms. They may also be useful for addictions like alcohol, smoking and opioids, as well as some eating disorders, and they even seem to help sleep apnea, and some obesity-related cancers. That's quite a list.

The research continues apace, and new drugs in the same class are still being developed. GLP-1 agonists, or something similar, may still turn out to be the wonder drugs for which we have searched so long. But, even so, can we do something about that advertising?