When Ozempic fails: a trial helps perceive why some sufferers lose half as a lot weight as others | Health & Wellness | EUROtoday

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Ozempic has not given Ana the anticipated outcomes. She reads articles in every single place that speak about miracle medication and it makes her indignant, as a result of in her case the outcome has been fairly restricted. “I started using it two years ago, by medical prescription,” she explains in an alternate of messages. “I had to stop due to stomach problems, when I had lost two or three kilos.” She obtained them again. With Saxenda, a earlier medicine from the identical household, issues had been considerably higher, because the unintended effects weren’t as sturdy. She misplaced 5 kilos in three months. These outcomes are very removed from the typical. GLP-1 receptor agonists have been proven to trigger a lack of round 15% of the affected person's weight, however this magic quantity is a median; there are people who find themselves a lot decrease, like Ana. She has misplaced weight, however not what she anticipated. his physician was ready. Neither she nor he are very clear on what to attribute it to.

A research introduced this week on the Digestive Disease Week I might need the reply. According to it, a genetic evaluation can predict every affected person's response to therapy with this drug. This abstract consolidates the work carried out during the last 12 years by the Mayo Clinic in Michigan (United States).

The researchers used a machine studying course of to determine sufferers with a phenotype, recognized as “hungry gut,” related to better weight reduction in response to semaglutide. After 12 months of therapy with semaglutide, the hungry intestine sufferers misplaced 8.8 kilos in comparison with 4.5 kilos within the different group. Almost double. “It is quite robust evidence,” says Andrés Acosta, a gastroenterologist and affiliate professor on the Mayo Clinic, in a videoconference.

GLP-1 agonists act within the gut and ship a sign to our mind to make us really feel full. All of this is called the gut-brain axis, the biochemical signaling between the gastrointestinal tract and the central nervous system. “We have taken all the genes that are in this axis,” explains Acosta. “And we have analyzed them with artificial intelligence to try to predict and create a model that tells us if this axis is normal or if it has many genetic variables.” And what they discovered, after analyzing 84 folks, is that those that should not have variants reply significantly better to therapy.

“They are pilot studies, which will have to be evaluated in more patients, but it is seen that in patients with intestinal hunger it is more effective,” explains Cristóbal Morales, endocrinologist on the Virgen de la Macarena hospital in Seville. “It is interesting, not as a maximum level of evidence, but it highlights the need to phenotype this very complex disease. “This is going to help us treat it,” he says.

The World Health Organization defines weight problems as “a multifactorial disease that is due to an obesogenic environment, psychosocial factors and genetic variants.” The Mayo Clinic evaluation focuses on the latter case. “It is one of the most important factors to understand who responds best to this treatment,” Acosta acknowledges.

The evaluation is in keeping with the present development of precision or customized drugs. Javier Escalada San Martín, director of the Department of Endocrinology and Nutrition on the Clínica Universidad de Navarra, believes that we face an “interesting” discovering, which seeks effectivity, detecting these individuals who will reply higher to sure medication. However, Escalada recollects that the proposal to divide sufferers into 4 phenotypes is controversial. In addition to the hungry intestine famous on this research, there can be mind starvation, emotional starvation, and sluggish combustion, in response to the division of Acosta's group. “But not the entire scientific community agrees because it is difficult to find pure phenotypes,” says Escalada.

Acosta defends his concept by evaluating the way in which we perceive weight problems with that of ldl cholesterol. “Everyone knows that there is good cholesterol, bad cholesterol, triglycerides… In reality there are more than 35 types of cholesterol. But talking about three large groups helps us understand and better manage the disease,” he explains.

In a current publication in the scientific journal Lancet It was analyzed how any intervention in opposition to weight problems obtains heterogeneous outcomes, with individuals who barely lose 5% of their preliminary weight and others who lose as much as 40%. Escalada factors to this research to clarify how no therapy works equally nicely for everybody. And in any case, he clarifies, the brand new generations of GLP-1 agonists are more and more extra environment friendly, “with retatrutide [actualmente en fase dos] 100% of the treated people lost at least 5% of their initial weight; That is, there were no non-responders,” he explains.

Albert Lecube, endocrinologist on the Arnau de Vilanova University Hospital in Lleida, highlights the significance of this research, particularly for the longer term. “Knowing that there is a genetic basis that affects you now is important,” he says, “but there are not many pharmacological treatment alternatives either.”

In Spain, Ozempic is the one newest technology GLP-1 agonist accessible available on the market, and with main provide issues. But there are a handful of alternate options pending commercialization, and lots of others are within the testing part. So, explains Lecube, understanding the affected person's response shall be important. “Now it can serve to modulate your expectations, but in the future we will be able to adjust the medicine that works best for each patient,” she says.

In any case, all of the specialists consulted agree that these research endorse the thought, more and more widespread, that we can not speak about weight problems, however about weight problems. There isn’t any single response to a therapy, and even much less so with a multifactorial illness equivalent to weight problems.

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