The Eli Lilly do Brasil laboratory had Mounjaro (tirzepatide) approved by the National Health Surveillance Agency (Anvisa) on September 25. The drug promises to be more effective in controlling obesity and diabetes than its competitor Ozempic (semaglutide), which was approved in 2018 and has become a sensation as a means of losing weight, including for aesthetic reasons. Obesity is the most common chronic disease in the world, affecting approximately 650 million adults.
Endocrinologist Antonio Roberto Chakra, from the Syrian-Lebanese Hospital, says: “This new class of medicines constitutes a revolution in the treatment of obesity.” Al-Shaab newspaper. “Moonjaro comes across as a slightly superior drug to Ozempic, but it’s hard to say in practice how the comparison will fare.” For the chakra, the exorbitant price of medications deserves to be called “financial toxicity”, because in addition to being expensive, they require constant use.
In his opinion, medicines should not be used for purely aesthetic purposes, but for health purposes, where the aesthetic effect is just a bonus, and not the main goal. He disagrees with Anvisa releasing Ozempic for over-the-counter use, a requirement that should be in place in Mounjaro’s case, because they are new injectable drugs. He explains that injections may eventually replace bariatric surgery, but this must be determined on a case-by-case basis.
The minimum price for Ozempic found in the report was R$833.00 per box with 1-month doses. Warning: The market is already full of scams claiming the “natural effect” of the drug, sometimes imitating the brand name. Mounjaro has not yet shown up in searches in Brazilian pharmacies, but its price must be higher, as it sells for the equivalent of R$5,000 per month in the United States.
How do Mongaro and Ozimbic work?
Both medications mimic the action of hormones secreted by the intestines after eating, which produce a feeling of fullness. The difference is that while Ozempic mimics one hormone (GLP-1), Mounjaro mimics two hormones (GLP-1 and GIP). The effectiveness of Mongaro has been proven in study
It was published in July 2022 in the medical journal New English Journal of MedicineIn which more than 2,500 people participated, with an average weight of 105 kg. After 72 weeks of treatment, those in the drug group lost an average of 15% to 21% of that weight, depending on the dose. In comparison, those who did not take it (the placebo group) lost only 3%.
As for competitor A Stady 2021 with Ozempic in a similar group, in the same journal, showed an average loss of 15% after 68 weeks, a loss obtained with the lowest dose of Mounjaro. This measure of weight loss has been confirmed by A Stady Long term – 104 weeks – published in Natural medicine In 2022. Both medications are given as a weekly injection, and the recommendation is that diet and exercise be followed simultaneously. The most common side effects are nausea, diarrhea, stomach pain, and constipation.
Follow-up time is important to understand effectiveness, as the long-term tendency for patients who do not change their habits is to gain a significant amount of weight back. One Stady
Published last year in the magazine Diabetes, obesity and metabolism
Note that after 120 weeks of stopping treatment with Ozempic, participants regained 67% of the weight they lost. This result is still very positive, especially compared to other weight loss methods.
Given the similarity of the drugs, it is possible to infer the safety profile of Mounjaro, which is still under investigation, from the already well-established standard of Ozempic, which has been studied for a longer period. Dr. Glaucia Carneiro, Professor of Endocrinology and Head of the Obesity Group at Univisp, said that “clinical studies have shown tolerability and safety consistent” with the general class of these drugs.
study Natural medicine, who evaluated the safety of semaglutide by following participants for two years, noted that gastrointestinal adverse events are “mostly mild to moderate.” While 5.9% of participants withdrew from the study after reporting adverse events, the number was similar to 4.6% of those who withdrew from taking placebo for the same reason. Since a placebo cannot cause these events, this indicates that the drug is completely safe.
Nausea, diarrhea, vomiting, or constipation were reported more in the drug group than in the placebo group, but the difference was not significant and these effects were generally transient and mild. There was no case of inflammation of the pancreas, which is the organ that is supposed to be affected by the mechanisms of action. The most serious events observed were gallbladder disease and malignancy. However, while gallbladder problems occurred more frequently in the group taking Ozempic, cancer was more common in the placebo group. The main limitation of the study was the small number of subjects involved: 152 in the treatment group and 152 in the placebo group.
Surprising effects on addicts
Carneiro notes that there is an interesting effect of these drugs: “Some patients who use the drug report a loss of interest in addictive and compulsive behaviors, such as drinking alcohol, smoking, shopping, biting their nails, and biting their skin.” It is as if the satiety produced by the hormones secreted by the digestive system, and imitated by medications, is a general satiety, not limited to food.
The expert believes that these effects, which have not yet been confirmed, are related to the dopamine and reward system in the brain. “The studies are preliminary and more scientific evidence is needed,” she explains. His opinion regarding the aesthetic application is that because of the safety of the drugs, “they should be approved soon to help treat obese and non-diabetic individuals in Brazil.”
Carneiro agrees with Chakra: “It has brought about a real revolution in the treatment of obesity, which is a chronic disease and must be treated as such.” The endocrinologist said that the baseline weight loss rate for non-diabetic participants in a particular study was 22.1%, “a result that has not been achieved with any existing treatment to date.” For severe obesity, and for patients who do not respond well to Monjaro, she believes that bariatric surgery will continue to be an important treatment and that it is not exclusive, as medications in this category can help the person who has the surgery maintain a low weight. . “The treatments will be synergistic,” he concludes.
“Obesity is an epidemic, but the health system takes priority over other diseases, and it will not be able to bear the costs” of medicines, Chakra says. He believes that women who want to become pregnant and are of childbearing age should avoid Ozempic and Mongaro, due to the lack of specific safety tests on them and their natural effect on the pregnant woman’s appetite.
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