Semaglutide, Pg13

Key Highlights:

• New anti-obesity drugs mimicking intestinal hormones like GLP-1 and GIP show promise in reducing body fat and improving cardio-metabolic health.
• The Director General of Health Services has imposed prescribing restrictions due to potential misuse and adverse effects.
• Semaglutide, a GLP-1 agonist, was added to the WHO's list of essential medicines in 2025 for treating obesity and diabetes.
• Cardiovascular diseases and diabetes cause 23-25 million deaths annually worldwide, with a third of all deaths in India.

Detailed Insights:

• India's generic drug industry significantly impacted access to affordable medicines, especially during the HIV-AIDS pandemic, after adopting "process patenting" in 1970.
• As semaglutide patents expire, Indian manufacturers aim to produce affordable generic versions, potentially costing 25-30% of the current price.
• The Doha Declaration (2001) allows countries to relax patent rules for public health threats, relevant to cardiovascular diseases and diabetes.
• GLP-1 agonists can help manage high body fat, diabetes, hypertension, and abnormal blood lipids, particularly addressing inflammation in abdominal fat common among Indians.
• Potential adverse effects of these drugs include gastrointestinal issues, mental health disturbances, visual problems, bone thinning, and sarcopenia (muscle loss), a concern for Indians with low lean muscle mass.
• Discontinuing these drugs may lead to rebound weight gain and loss of cardio-metabolic benefits, necessitating prolonged therapy with associated costs and side effects.

Scientific/Technical Concepts Involved:

• GLP-1 (Glucagon-like Peptide): An intestinal hormone that stimulates insulin release and reduces glucagon secretion, lowering blood sugar levels.
• GIP (Gastric Inhibitory Peptide): An intestinal hormone that stimulates insulin secretion in response to glucose.
• Sarcopenia: The loss of skeletal muscle mass and strength, often associated with aging or certain medical conditions.