A family of diabetes drugs that includes the internet-famous Ozempic is associated with an increased risk of gastrointestinal issues, according to international researchers.
The team used information from a health database to compare the potential side effects of glucagon-like peptide 1 (GLP-1) agonists liraglutide (Victoza) and semaglutide (Ozempic) with an obesity medication in an unrelated drug class, bupropion-naltrexone (also known as Contrave).
GLP-1 agonists, while commonly given to diabetes patients, have gained popularity in recent years due to their off-label prescriptions to encourage weight loss due to their side effects, which include increasing satisfaction after eating, decreasing appetite, and moving food slower through the bowels.
“As a result, off-label prescription of these drugs for weight loss has increased to the point that in the UK there is a shortage of GLP-1 agonists for type-2 diabetes that is expected to last until 2024,” Dr Ian Musgrave from the University of Adelaide, who was not involved in the study, told the AusSMC.
In the study, the team found the use of GLP-1 agonists was associated with an increased risk of pancreatitis, gastroparesis (delayed gastric emptying), and bowel obstruction.
While this may raise some concerns for those who take these kinds of medications, independent researchers have told the AusSMC the research should be interpreted with caution.
“Those already on anti-obesity treatment should not stop their medication, especially if they have no symptoms or side effects, however, should speak to their doctor if they have any concerns,” Senior Bariatric Medical Practitioner at St George Private Hospital, Dr Georgia Rigas said, adding that everything we take – or choose not to take – comes with risks.
Dr Musgrave agreed, adding that Contrave, the drug GLP-1 agonists were compared to, also comes with its own list of side effects.
So as with any medication, the benefits and risks must be carefully weighed up for each patient.
“Naltrexone-bupropion has a lower incidence of serious gastrointestinal side effects compared to GLP-1 agonists, it also has side effects that must be carefully considered such as seizures, high blood pressure and suicidal thoughts or actions,” he said.
“Regardless of whether medications are being prescribed for obesity, diabetes or other conditions, their risks and benefits should always be considered in relation to the goals and needs of the individual patient,” Associate Professor Priya Sumithran from Monash University added.
Further, while the study attempted to look at the drugs for their use in weight loss by including data on obesity and comparing the drugs to another weight loss drug, A/Prof Sumithran said the data was not clear on whether patients were actually taking GLP-1 agonists for weight loss or not.
She said the number of patients taking GLP-1 agonists also far outnumbered patients taking bupropion-naltrexone, which may have also affected the final statistics.
All in all, experts seem to agree that the study findings are consistent with what is already known about GLP-1 agonists when taken by diabetes patients, and add the incidence of gastrointestinal issues is still low overall, despite the increased risks.
But the study findings add to the body of evidence which can help doctors and patients make better-informed decisions together down the track. For example, if a patient is already prone to gut issues, doctors may suggest an alternative medication.
“The key is patients need to be informed of what the medical evidence tells us, have it put it into context, with a goal to assist them in making an informed decision,” said Dr Rigas.
“Furthermore, empowering patients with a list of 'what to look out for' and what to do about it if they develop symptoms during and out of office hours.”
You can read the full Expert Reaction here
This article originally appeared in Science Deadline, a weekly newsletter from the AusSMC. You are free to republish this story, in full, with appropriate credit.
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