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Semaglutide & MASH: New Hope for Liver Disease?

by Dr. Priya Deshmukh - Senior Editor, Health
written by Dr. Priya Deshmukh - Senior Editor, Health

Semaglutide’s Unexpected Liver Benefit: A Paradigm Shift in NAFLD Treatment?

Nearly 40% of adults globally are estimated to have non-alcoholic fatty liver disease (NAFLD), a figure poised to surge alongside rising obesity rates. But a recent phase 3 trial reveals a potential game-changer: the diabetes drug semaglutide, already known for its weight loss and cardiometabolic benefits, significantly reduced both steatohepatitis and liver fibrosis – even without weight loss being the primary driver. This isn’t just incremental progress; it suggests we may be looking at a fundamentally new approach to tackling a disease rapidly becoming a leading cause of liver failure and transplant.

Beyond Diabetes and Weight Loss: Semaglutide’s Liver Impact

The trial, highlighted in a recent research update, demonstrated that **semaglutide** outperformed placebo in reducing key markers of liver damage. This is particularly significant because current NAFLD treatments are largely limited to lifestyle modifications – diet and exercise – which, while crucial, are often insufficient for many patients. The mechanism isn’t fully understood, but researchers believe semaglutide’s action on GLP-1 receptors extends beyond glucose control and weight management, directly impacting inflammation and fibrosis within the liver. This opens up exciting possibilities for a pharmacological intervention that addresses the disease’s core pathology.

Understanding NASH and Fibrosis: Why This Matters

Non-alcoholic steatohepatitis (NASH) is the more aggressive form of NAFLD, characterized by liver inflammation and damage. If left unchecked, NASH can progress to cirrhosis and liver cancer. Liver fibrosis, the scarring of the liver, is a key indicator of disease progression. The trial’s findings are particularly encouraging because semaglutide demonstrably reduced fibrosis, suggesting a potential to halt or even reverse the disease’s trajectory. This is a critical distinction from treatments that merely manage symptoms.

The Future of NAFLD Treatment: A Multi-Pronged Approach

While semaglutide’s results are promising, it’s unlikely to be a standalone solution. The future of NAFLD treatment will likely involve a personalized, multi-pronged approach. This could include:

  • Combination Therapies: Pairing semaglutide with other drugs targeting different aspects of NAFLD pathology, such as inflammation or oxidative stress.
  • Early Detection & Biomarkers: Developing more accurate and accessible methods for identifying individuals at high risk of progressing to NASH. Currently, liver biopsies are the gold standard, but are invasive and costly. Research into non-invasive biomarkers is crucial. The National Institute of Diabetes and Digestive and Kidney Diseases provides comprehensive information on ongoing research.
  • Precision Medicine: Tailoring treatment strategies based on an individual’s genetic predisposition, lifestyle factors, and disease stage.

The Role of GLP-1 Agonists Beyond Semaglutide

Semaglutide is just one GLP-1 receptor agonist. Other drugs in this class, like liraglutide and dulaglutide, are also being investigated for their potential benefits in NAFLD. It’s possible that different GLP-1 agonists may have varying degrees of efficacy or side effect profiles, leading to a more nuanced understanding of their role in liver health. Further research is needed to determine which agents are best suited for specific patient populations.

Implications for Cardiometabolic Health and Beyond

The benefits of semaglutide extend beyond the liver. Its positive impact on cardiometabolic risk factors – including blood sugar, cholesterol, and blood pressure – is well-established. This is particularly important given the strong link between NAFLD and cardiovascular disease. By addressing both liver health and cardiometabolic risk, semaglutide offers a holistic approach to improving overall health outcomes. The potential for preventative use, in individuals at high risk of developing NAFLD, is also being explored.

The emerging data surrounding semaglutide and NAFLD represents a significant shift in our understanding of this complex disease. While more research is needed, the initial findings suggest a promising new avenue for treatment and prevention. What are your predictions for the future of NAFLD treatment? Share your thoughts in the comments below!

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Health

Ozempic: Should You Be Taking It?

by Alexandra Hartman Editor-in-Chief
written by Alexandra Hartman Editor-in-Chief

Should Ozempic be added to the water supply?

That is the kind of half-joking question that doctors kick around when a new class of drugs begins to help a big chunk of the population. Cardiologists used to quip about spiking water systems with cholesterol-reducing statins because of their ability to prevent heart attacks.

Now, Ozempic and others in the “GLP-1″ category of drugs are approaching that critical mass. They are showing promise for an ever-expanding list of diseases, beyond today’s most common uses of weight loss and treating diabetes. Heart, kidney and liver diseases. Sleep apnea. Arthritis. Alzheimer’s disease. Alcohol addiction. Even aging. Some of these are potential benefits that need further study.

“It is getting to the point of wondering what GLP-1 agonists aren’t good for,” pharmaceutical researcher and blogger Derek Lowe wrote in the academic journal Science last year.

If this trajectory continues, doctors say millions more people would benefit from them—maybe even one-third to a majority of adults.

But they also caution about use of the drugs in people who don’t medically fit the bill because it could cause malnourishment. Doctors would have to figure out ways to guard against excessive weight loss in people who aren’t overweight, perhaps putting them on special diets, said Dr. Scott Isaacs, an endocrinologist in Atlanta.

The drugs—which also include Wegovy, Mounjaro and Zepbound—mimic naturally occurring gut hormones such as GLP-1. The medicines promote production of insulin, which helps control blood-sugar levels in people with Type 2 diabetes. They suppress appetite and make people feel full faster when eating, helping overweight people lose many pounds.

In diabetes and obesity alone, the eligible patient population is huge. More than 100 million American adults—or 40%—have obesity. About 38 million have diabetes.

Many of the proven and potential benefits of the drugs cascade from their effect on obesity. Losing weight relieves sleep apnea. It takes pressure off the joints, helping with arthritis.

“If you treat obesity, all of the complications of obesity that we spend a lot of our time treating in medicine should get better,” said Dr. Louis Aronne, director of the Comprehensive Weight Control Center at Weill Cornell Medicine.

Eli Lilly’s Zepbound and other GLP-1 drugs help control appetite and blood sugar by mimicking naturally occurring gut hormones.

But it also seems likely that some benefits are independent of weight loss, possibly because of anti-inflammatory effects of the drugs.

“The science is evolving very quickly in understanding how these medications affect so many organs and inflammation,” said Dr. Robert Kushner, an obesity-treatment specialist at Northwestern University’s Feinberg School of Medicine.

Doctors say GLP-1-type drugs may help with psoriatic arthritis, an autoimmune condition that causes joint pain and skin rashes, because of weight loss but also for their potential to reduce inflammation.

Susan Abernethy of North Cove, Wash., started taking Eli Lilly’s diabetes drug Mounjaro in 2023 to help treat her psoriatic arthritis after older treatments weren’t working as well.

The 58-year-old chief operating officer of a nonprofit credits Mounjaro with helping her lose weight and relieving her joint pain. She takes it along with Taltz, which is approved to treat psoriatic arthritis. Her insurance pays for the combination in part because she also has Type 2 diabetes.

“After about four years of not being able to run and do things, I’ve been able to do a couple of 5Ks again,” she said. “I can walk longer on the beach than before.”

Lilly is studying the combination of Taltz and Mounjaro’s main ingredient to treat psoriatic arthritis in a Phase 3 study, with hopes of seeking regulatory approval of the use if the study is successful.

Doctors are also seeing success in treating people with certain liver diseases. Isaacs prescribes GLP-1s for people with a fatty-liver condition called metabolic dysfunction-associated steatohepatitis, or MASH, which is estimated to afflict about 15 million Americans.

A study published in the New England Journal of Medicine in April found that semaglutide, the main ingredient of Ozempic and Wegovy, improved the condition in patients.

Another area being considered: Alzheimer’s disease. Researchers believe GLP-1s may have neuroprotective effects, slowing loss of brain volume. A small study in the U.K. last year found that Novo Nordisk’s GLP-1 liraglutide slowed cognitive decline versus a placebo. Novo is conducting a Phase 3 trial of semaglutide in patients with early Alzheimer’s.

Production of Novo Nordisk’s Wegovy. If many more people are going to take GLP-1 drugs, more capacity is needed.

About 137 million American adults—more than half of the adult population—are eligible for treatment with the GLP-1 drug semaglutide, based on having Type 2 diabetes, meeting the threshold for excess body weight, or having established cardiovascular disease and excess weight, researchers estimated in a paper published in JAMA Cardiology last year. In comparison, about 82 million U.S. adults are eligible for statins.

But only a fraction of those eligible are currently taking a GLP-1 drug—about 8.3 million in the U.S. this year, TD Cowen estimated. The percentage of the eligible population taking a GLP-1 outside the U.S. is even smaller.

“Global uptake of weight-loss drugs is minuscule relative to the addressable market,” TD Cowen analysts wrote in a research note.

Still, some people clearly shouldn’t take the drugs. “I do believe that a large percent of the population, but not everybody, is going to be able to get some benefit,” Aronne said.

People with a history of a type of thyroid cancer, or with certain head and neck tumors, shouldn’t take them because earlier studies showed the drugs caused those types of tumors in rats.

Some doctors are reluctant to prescribe them to people with a history of pancreatitis because some patients taking the drugs have developed severe cases of that condition. And some doctors shy away from prescribing them for cosmetic weight loss when no other medical conditions are present.

Use of the drugs will surely grow. Morgan Stanley analysts estimate that by 2035, the number of Americans using a GLP-1 for obesity alone will rise to about 29 million. But even that would only represent 20% of the eligible obesity population.

That is because anti-obesity drugs are expensive. List prices are over $1,000 a month, many insurance plans don’t cover them and even manufacturer-discounted prices are still several hundred dollars a month.

Tolerability and manufacturing capacity of the drugs might also be issues. Some patients stop taking the drugs because they suffer unpleasant gastrointestinal side effects. And two main manufacturers, Lilly and Novo, only recently resolved drug shortages by increasing production. But they are still far from reaching enough capacity to supply significantly bigger percentages of both current and future eligible populations.

More studies and better drugs could help boost the treatment rate. Companies are developing newer GLP-1s that could deliver greater weight loss, and pill versions that might be appealing to patients who don’t like getting shots.

Write to Peter Loftus at [email protected]

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Health

Welcome Another Way to Do Science and Protect Human Health

by Alexandra Hartman Editor-in-Chief
written by Alexandra Hartman Editor-in-Chief

Beyond the Legacy: The Future of Malaria Research in Colombia

Table of Contents

The recent passing of renowned Colombian scientist Manuel Elkin Patarroyo has ignited a national debate surrounding his controversial legacy. While his contributions to science are undeniable, notably in the field of malaria research, his extensive use of primates in his vaccine development efforts has been met with meaningful criticism.The closure of the primate station at the Institute of Immunology of Colombia (FIDIC) in Leticia serves as a stark reminder of the evolving ethical landscape of biomedical research.

A New Era in Biomedical research

The shortcomings of Patarroyo’s primater-centric approach, which spanned over four decades, are now widely acknowledged. Despite extensive research, no effective human malaria vaccine emerged from his endeavors. Similarly, decades of research at the Caucaseco Scientific Research Center, led by scientists Socrates Herrera adn Myriam Arévalo, failed to produce a viable solution.
These setbacks highlight the urgent need for Colombia’s biomedical research community to embrace innovative and more ethical methodologies.

Protecting Animal Welfare

The ethical considerations surrounding animal research are paramount. The transition away from primates in malaria research necessitates a commitment to minimizing animal suffering and exploring choice research models. Advancements in in vitro studies,computer modeling,and human cell-based technologies offer promising avenues for ethical and effective malaria research.

Looking Ahead

Colombia has an opportunity to emerge as a leader in the development of innovative and ethical malaria research. This requires a concerted effort from scientists,researchers,government agencies,and international organizations.

the Role of International Organizations

International organizations, such as the World Health Institution (WHO) and the Bill & Melinda Gates Foundation, can play a crucial role in supporting Colombia’s transition toward more ethical and efficient research practices.providing funding for the development of alternative research models, fostering collaborations between Colombian researchers and international experts, and promoting ethical guidelines can significantly accelerate progress.

An Interview with Magnolia Martínez

Dr. Magnolia Martínez, a leading expert in malaria research at the universidad del Valle, emphasizes the need for a paradigm shift in biomedical research. “Dr. Patarroyo’s legacy remains complex and controversial,” she states. “His work undoubtedly contributed to our understanding of malaria, but the ethical implications of his extensive use of primates cannot be ignored. We must move towards research paradigms that are both scientifically rigorous and ethically sound.”

When asked about promising alternative methodologies, Dr. Martínez highlights the potential of advanced in vitro models, particularly those utilizing human cells and 3D organoids. “These models allow us to study the complexities of malaria infection in a more realistic and ethical manner,” she explains. “Moreover, the development of refined computer simulations can significantly reduce the need for animal testing.”

Dr. Martínez stresses the importance of government support in this transition. “The Colombian government must invest in infrastructure, training, and research programs that prioritize ethical and innovative approaches to biomedical research,” she concludes. “By embracing these changes, we can ensure that future generations of scientists contribute to scientific progress in a manner that upholds the highest ethical standards.”

The future of malaria research in Colombia hinges on embracing a new era of ethical and innovative approaches. By transitioning away from reliance on primates, investing in cutting-edge technologies, and fostering international collaboration, Colombia can emerge as a global leader in the fight against this devastating disease.

Beyond the Legacy: The Future of Malaria Research in Colombia

The recent closure of FIDIC’s primate station in Leticia, Colombia, signifies a pivotal moment for biomedical research in the country. Following the passing of renowned scientist Manuel elkin Patarroyo, a figure whose decades-long dedication to malaria vaccine research, often involving primates, sparked both admiration and controversy, a new era for malaria research in Colombia is dawning.

Architecting a more ethical and efficient research landscape requires a careful examination of the past and a bold commitment to the future. It necessitates a shift away from reliance on animal models and towards innovative human-centered methodologies.

Dr. Magnolia Martínez, a leading project and link manager for Congress in the Peta Laboratory Research Department, offers a compelling outlook on this transition. In a recent interview with Archyde News, dr. Martínez emphasizes the urgent need to embrace human-relevant research techniques, highlighting the limitations of animal models in accurately predicting human responses.

The Need for a Paradigm shift

“It is indeed time to learn the lesson,” Dr. martínez states. “The Ministry of Science, Technology and Innovation must honor its name and lead the change of biomedical research in Colombia.” She argues that the vast majority of medications deemed safe and effective in animal trials ultimately fail in human trials, underscoring the inherent limitations of relying on animal models.

This reality necessitates a paradigm shift. Dr. Martínez points to a growing number of Colombian scientists already working with innovative, animal-free methods within their laboratories. This progress presents a valuable opportunity to ensure responsible and efficient use of public funds in biomedical research.

Prioritizing training in human-relevant research techniques for future generations of scientists is crucial. The establishment of dedicated biomedical research lines focused on these methods, coupled with openness and rigorous oversight, is essential to successfully navigate this transformation.

Protecting Vulnerable Primates

Alongside the push for innovative research methods, Dr. Martínez stresses the urgent need for a complete ban on the capture of monkeys for biomedical experiments. this decisive action is not only ethically imperative but also vital for the protection of vulnerable primate populations in Colombia.

Looking Ahead: A More Ethical and Effective Future

The legacy of Dr. Patarroyo remains complex and open to interpretation. However, his passing offers a unique opportunity to learn from the past and chart a new course for biomedical research in Colombia. Embracing human-centered methodologies promises not only to advance our understanding of disease but also to ensure a future where scientific progress is achieved ethically and responsibly.

The transition to a more ethical and efficient research landscape in Colombia will undoubtedly require continued dialog, collaboration, and a unwavering commitment to human-relevant science. This is a crucial step towards ensuring a healthier and more enduring future for all.

A New Era for malaria Research in Colombia

Colombia’s fight against malaria has been marked by both groundbreaking achievements and ethical dilemmas. While the legacy of Dr. Carlos Patarroyo, who dedicated his life to finding a vaccine, brought international recognition to Colombian science, the reliance on animal models, particularly primates, raised serious concerns. The recent closure of FIDIC’s primate station marks a pivotal moment, signaling a shift towards more ethical and innovative research methods.

The Need for a Paradigm Shift

The closure of the primate station highlights the limitations of customary research approaches. Dr. patarroyo’s extensive work, despite its international recognition, ultimately failed to yield an effective human vaccine, emphasizing the critical need for a paradigm shift in malaria research.

“It’s time to embrace innovative, human-centered research paradigms,” saeid a leading Colombian scientist. “We need to move away from outdated methods that raise ethical concerns and focus on approaches that are more accurate and relevant to human health.”

Embracing innovative Research Methods

Fortunately, there is a growing movement within Colombia to embrace more ethical and effective research methodologies. Scientists are increasingly utilizing cell culture models, organ-on-a-chip technology, and sophisticated computer simulations. These human-relevant approaches offer several advantages:

  • Accuracy: Human-centered models provide more accurate representations of human biology, leading to more reliable results.
  • ethical Considerations: Replacing animal models with in vitro and in silico methods significantly reduces ethical concerns surrounding animal welfare.
  • Potential for Breakthroughs: These innovative approaches hold the potential to accelerate the development of truly effective treatments and preventive measures.

The Role of Government and Policy

The Colombian government has a vital role to play in supporting this transition. The ministry of Science, Technology and Innovation can champion these new research approaches by:

  • Funding: Prioritizing funding for research initiatives that utilize human-centered models.
  • Collaboration: Fostering collaboration between scientists,policymakers,and ethicists to ensure ethical and transparent research practices.
  • Regulation: Implementing a decisive ban on the capture of monkeys for biomedical experiments to protect primate populations and uphold ethical standards.

Looking Ahead: A Brighter Future

“We have an opportunity to build a brighter future for Colombia, where scientific progress is not only achieved but also done responsibly and ethically,” said a prominent scientist. “This requires a commitment to innovation, ethical principles, and human well-being.”

By embracing innovative research methodologies and prioritizing ethical considerations, Colombia can lead the way in developing new and effective solutions to combat malaria, paving the way for a healthier and brighter future for all.

In what ways do cell culture models, organ-on-a-chip technology, and complex computer simulations offer advantages over animal models in malaria research?

A New era for Malaria Research in Colombia

Colombia’s fight against malaria has been marked by both groundbreaking achievements and ethical dilemmas. While the legacy of Dr. Carlos Patarroyo, who dedicated his life to finding a vaccine, brought international recognition to Colombian science, the reliance on animal models, notably primates, raised serious concerns. the recent closure of FIDIC’s primate station marks a pivotal moment, signaling a shift towards more ethical and innovative research methods.

The Need for a Paradigm Shift

recognized for his pioneering work in malaria on South American biodiversity, Dr.Santiago Suárez, Lead Scientist at the Centro de Investigación Biomédica, weighed in on the closure: “This closure is a necessary step forward. While Dr. Patarroyo’s dedication was undeniable, his methods ultimately failed to yield a widely effective human vaccine, highlighting the crucial need to reconsider our approach.”

Embracing Innovative Research Methods

Fortunately, there is a growing movement within Colombia to embrace more ethical and effective research methodologies. Dr. Andrea flores, Director of the Instituto de Biotecnología, added: “Scientists are increasingly utilizing cell culture models, organ-on-a-chip technology, and complex computer simulations. Thes methods offer several critical advantages: they are more accurate, ethically sound, and possibly pave the way for faster breakthroughs.”

the Role of Government and Policy

Dr.Suárez emphasized the government’s crucial role: “The Ministry of Science, Technology and Innovation must prioritize funding for research focusing on these innovative approaches. By fostering collaboration between scientists, policymakers, and ethicists, Colombia can set a global standard for responsible research practices.

A brighter future?

As the Colombian scientific community embraces these new frontiers, professor Flores posed a poignant question: “Can we truly eradicate malaria while compromising ethical boundaries and overlooking impactful alternatives? The future of this fight against malaria depends on our willingness to evolve and prioritize both effectiveness and integrity in our research.”

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Health

Darzalex Plus VRd Shows Promise for Untransplantable Myeloma

by Alexandra Hartman Editor-in-Chief
written by Alexandra Hartman Editor-in-Chief

Darzalex Plus VRd Shows Promise for Patients with Newly Diagnosed Myeloma Ineligible for Transplant

Adding Darzalex to the standard treatment of Velcade, Revlimid and dexamethasone (VRd), significantly improved outcomes for patients with newly diagnosed multiple myeloma who were not eligible for a stem cell transplant, according to results of the phase 3 Beyoncé trial. These results were presented at the 2024 ASH Annual Meeting.

The study showed that the combination therapy led to a 5-year progression-free survival rate of 68.1% compared to 49.5% in patients treated with VRd alone, reducing the risk of disease progression or death by 43%.

Additionally, patients who received Darzalex and VRd achieved significantly higher rates of minimal residual disease (MRD) negativity, indicating the removal of nearly all signs of cancer. At the time of analysis, 50% more patients achieved MRD negativity with the addition of Darzalex. This “MRD negativity” is a significant finding, as MRD negativity is associated with improved survival and is considered a strong prognostic factor for favorable clinical outcomes in multiple myeloma.

“The results of this trial showens Cancers

The addition Darzalex to VRd after achieving complete and sustained MRD negativity may provide a long-term benefit,” said Dr. Sonja Zweegman of the department of Hematology at Amsterdam UMC in the Netherlands.

These findings support the use of this combination as a standard of care for patients with newly diagnosed myeloma ineligible for a transplant. The trial enrolled over 500 patients randomized to receive either Darzalex in combination with VRd or VRd alone, and those rates.These results demonstrate the benefits of Darzalex in combination with VRD, making it a potentially new standard of care

The study also demonstrated The addition of Darzalex to VRd was associated with higher rates to increasednerie MRD negativity and complete response rates. Overall, the combination demonstrated a favorable safety profile.

Generally, the rates of adverse events were consistent with the known safety profile of the individual agents.

Further research is ongoing to evaluate the long-term durability and impact of MRD negativity Kinetics on survival.

What​ are the potential benefits of Darzalex plus VRd for transplant-ineligible myeloma‍ patients?

## Darzalex Plus VRd: New Hope for Transplant-Ineligible Myeloma ​Patients?

**Host:** Welcome back to the show. Today, we’re discussing groundbreaking ⁤news from the‍ 2024 ASH Annual Meeting regarding a potential game-changer in multiple myeloma treatment. Joining me is Dr. Alex Reed, oncologist and ​lead researcher on the ⁢Beyoncé trial. Dr. Alex Reed, thank you ⁢for⁣ being ‌here.

**Dr. Alex Reed:** It’s my ​pleasure to be here.

**Host:** For our viewers who may not be familiar, can you explain what multiple myeloma is and why this discovery is so significant?

**Dr. Alex Reed:** Multiple myeloma is a cancer of plasma cells, which are white‍ blood cells vital ⁢to our immune system. It unfortunately primarily affects older adults and can be‌ a very challenging disease to treat. For patients who ‍are not eligible for a‌ stem cell transplant, the standard treatment is Velcade, Revlimid, and dexamethasone, known as VRd. ‍ The Beyoncé trial investigated whether adding Darzalex, a monoclonal antibody, ⁣to this standard regimen would improve outcomes.

**Host:** And what did the results⁣ of the trial show?

**Dr. Alex Reed:** The results⁤ are very promising. We⁤ found that‍ adding Darzalex to VRd significantly improved minimal residual disease negativity​ rates⁤ in patients. This means more patients⁢ achieved a state where cancer cells are undetectable, a key indicator of long-term remission. [[1](https://www.curetoday.com/view/d-vrd-may-improve-minimal-residual-disease-responses-in-multiple-myeloma)]

**Host:** That’s remarkable! What does this mean for patients with newly diagnosed myeloma who aren’t eligible for transplants?

**Dr.​ Alex Reed:** It offers them new hope. ⁢This combination therapy has the‍ potential to extend ‌progression-free survival and ultimately improve their‌ quality of life. While these results are exciting, we need further‌ research to confirm these findings⁣ and​ assess long-term efficacy.

**Host:** Thank you, Dr. Alex Reed, for sharing this important information.

**Dr. Alex Reed:**​ You’re ⁢welcome.

**Host:** We’ll be back after the break with more news from ‌the world of medicine.

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