10-15% Non-Responders in Weight Loss Drug Clinical Trials
Increase Up to 20% After Full Market Release
Amid the rising popularity of obesity treatments such as 'Wegovy', 'Ozempic', and 'Saxenda', often hailed as 'miracle drugs', experts have noted that one in five people taking these medications did not experience weight loss effects.
On the 23rd (local time), the Associated Press (AP) cited expert opinions reporting that about 20% of users of obesity treatments in the 'GLP-1 receptor agonist' class were 'non-responders'. GLP-1 receptor agonists are substances structurally similar to the GLP-1 hormone. The GLP-1 hormone, primarily secreted when eating, acts on pancreatic beta cells to increase insulin secretion and suppress glucagon secretion, thereby lowering blood sugar levels. It also acts on the brain to suppress appetite and slows gastrointestinal motility, delaying glucose absorption.
On the 16th of last month, when the global pharmaceutical company Novo Nordisk's obesity treatment drug "Wegovy" was launched in Korea, a notice saying "Wegovy in stock" was posted at a pharmacy in Jongno-gu, Seoul.
The active ingredients in these obesity treatments include 'semaglutide', 'liraglutide', 'tirzepatide', and 'dulaglutide', with brand names such as Wegovy, Ozempic, Mounjaro, Zepbound, Saxenda, Trulicity, Rybelsus, and Victoza.
The AP reported that clinical trials showed that many patients treated with Wegovy or Mounjaro experienced weight loss effects of about 15-22%. Additionally, the proportion of patients classified as 'non-responders', with less than 5% weight loss, was approximately 10-15%. However, as these weight loss drugs have been widely marketed and used by tens of millions, some experts believe the non-responder rate may be higher than previously estimated.
Experts told AP, "GLP-1 receptor agonists do not work for every patient," and estimated that the non-responder rate is probably around 20%. Fatima Cody Stanford, a diabetes expert at Massachusetts General Hospital, pointed out, "The issue is explaining that each person responds differently."
Experts also noted that the effectiveness of these drugs is usually determined within a few weeks of administration. Weight loss effects typically appear early and continue as the dosage is increased. However, some patients who do not respond to a specific GLP-1 receptor agonist may respond to another drug within the same class. Furthermore, lifestyle factors such as diet, exercise, sleep, and stress play important roles in the success of weight loss in addition to medication. Katherine Saunders, an obesity treatment expert at Weill Cornell Medicine, said, "Obesity is a very complex disease and requires comprehensive treatment. If the prescribed drug is ineffective, there are always alternatives."
Meanwhile, on the 15th, the Ministry of Health and Welfare sent an official letter through the Korean Hospital Association to hospitals, requesting thorough medical evaluations to confirm patient eligibility before prescribing Wegovy. Wegovy, officially launched in South Korea in mid-last month, is a prescription-only medication requiring a doctor's approval. Using it without regard to patient condition can cause side effects. However, it has been reported that some medical institutions prescribe Wegovy through telemedicine without closely monitoring patients' conditions.
The Ministry emphasized in the letter, "Care should be taken not to promote the drug in a way that misleads patients into thinking it can be easily prescribed for dieting purposes," and "Particular caution is needed to prevent misuse of the medication during telemedicine consultations." They also requested that when prescribing Wegovy, healthcare providers comply with the Ministry of Food and Drug Safety's approved indications and inform patients in advance about possible side effects such as gallbladder disease or pancreatitis.
In South Korea, Wegovy can be prescribed to obese patients with a BMI of 30 or higher, or overweight patients with a BMI between 27 and 30 who have accompanying conditions such as hypertension or dyslipidemia.
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