‘Mounjaro may shift the Type 2 diabetes treatment paradigm'

[DP Interview] Thomas Forst, Chief Medical Officer at CRS Clinical Research Services, Germany

Dual GIP/GLP-1 receptor co-agonist Mounjaro demonstrates blood glucose reduction effect

Obesity rate among diabetes patients high..." Mounjaro will provide significant benefit with the weight loss effect confirmed in clinical trials."

Dr.

 

Thomas Forst, professor of Internal Medicine and Endocrinology at the Johannes Gutenberg University in Main, Germany (Chief Medical Officer, CRS Clinical Research Services, Germany)

Mounjaro has shown the most potent effect among incretin-based therapeutic agents.

 

Based on the dramatic effect it showed in reducing blood sugar levels and weight loss in clinical trials, we expect the drug will bring about many changes field of diabetes treatment.” Thomas Forst, Professor of Internal Medicine and Endocrinology at the Johannes Gutenberg University in Main, Germany (Chief Medical Officer, CRS Clinical Research Services, Germany), met with Dailypharm and said Mounjaro has the potential to become a game-changer in the field of diabetes.

 

Developed by the global pharmaceutical giant Eli Lilly, MUNJARO is a treatment for type 2 diabetes that acts on both the glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP).

 

People with type 2 diabetes have reduced incretin effect.

 

This decrease in incretin effect is primarily due to decreased secretion of GLP-1 and impaired insulin-stimulating effects of GIP.

 

GLP-1 and GIP are responsible for two-thirds of the postprandial insulin response.

 

By acting on GIP in addition to GLP-1, Mounjaro can further improve glycemic control.

 

Another of its strengths is its weight loss benefit.

 

In 3 clinical studies of patients with type 2 diabetes, more than half of patients lost 5% or more of their body weight.

 

As most patients with diabetes are pre-obese or obese, weight management is a critical issue.

 

This is why the analysis is that Mounjaro’s use could increase on-site.

 

The number of diabetes patients on the rise globally...emphasizing the importance of blood sugar management The number of diabetics is on the rise globally.

 

According to a study published in the medical journal Lancet, approximately 529 million people were living with diabetes worldwide in 2021.

 

By 2050, the number is expected to reach approximately 1.31 billion worldwide.

 

"With the increase in people with type 2 diabetes, complications such as hypertension and dyslipidemia are also on the rise," said Professor Forst.

 

"The increase in the incidence of diabetic complications means that the number of myocardial infarctions, strokes, and deaths from cardiovascular disease is also on the rise.

 

Therefore, there is a great need for the discovery of new therapeutic agents and their effective use.” The number of diabetes patients is also on the rise in Korea.

 

According to the 2021 fact sheet released by the Korean Diabetes Association (KDA), the prevalence of diabetes in adults aged over 30 years was 16.7%.

 

The number has been on the rise for the past 9 years.

 

The problem is in the treatment outcomes.

 

Despite being treated with oral hypoglycemic medications or insulin, 75% of diabetes patients in South Korea do not achieve a glycated hemoglobin (HbA1c) level below 6.5%, which is the treatment goal and pre-diabetes stage.

 

About 20% of people with diabetes have HbA1c levels above 8.0% and are in need of more aggressive treatment.

 

“HbA1c is a measure that gives you a big picture of how well a patient had controlled his or her blood sugar levels over a three-month period,” explained Professor Forst.

 

“Looking at fasting blood glucose level alone can lead to a false sense that your blood sugar is being well controlled.” Due to this importance in achieving an HbA1c level, there has been a need for a treatment that effectively lowers the blood glucose level.

 

Mounjaro demonstrated its blood glucose reduction effect in clinical trials.

 

In the SURPASS 1-5 trials, the drug showed greater HbA1c reduction than semaglutide, insulin, and other existing diabetes treatments.

 

More specifically, in the SURPASS 4-5 and SURPASS J-mono trials that were conducted on patients with type 2 diabetes, Mounjaro reduced HbA1c by a mean of -2.11% to -2.8%.

 

"In clinical trials, many patients achieved their target HbA1c level,” said Professor Forst.

 

“Even patients who did not achieve the HbA1c level goal of 6.5%, which is the diagnostic threshold for diabetes, benefited from the use of Mounjaro." 'Weight loss effect’ is another benefit of the diabetes drug Mounjaro One of the other strengths of Mounjaro is its weight-loss benefit.

 

In clinical trials, most patients who were administered the drug lost weight.

 

Currently, Mounjaro is approved as a treatment for type 2 diabetes and is not indicated for weight loss.

 

However, it is clear that weight loss can be of great benefit to diabetes patients.

 

In Korea, 78% of people with type 2 diabetes are pre-obese or obese.

 

The more obese the people with type 2 diabetes are, the more likely they are to have poor blood sugar control and develop diabetes-related complications Therefore, domestic and international clinical practice guidelines recommend that overweight or obese diabetics lose 5-15% of their body weight.

 

Major international academic societies also concur.

 

The American Diabetes Association (ADA) emphasized the importance and urgency of weight management in the overall care of people with diabetes in its 2024 diabetes treatment guidelines that it released recently.

 

According to the ADA, adult patients with type 2 diabetes can achieve better glycemic blood levels, blood pressure, and lipid control when they lose 3-7% of their body weight, and weight loss of 10% or more can have a positive long-term impact on reducing cardiovascular mortality.

 

In the SURPASS 4-5 and J-mono studies, 48-89% of patients who were administered Mounjaro achieved a weight loss of 5% or more.

 

In the SURPASS-2 study, Mounjaro also demonstrated faster weight loss results compared to the GLP-1 agent semaglutide.

 

"Weight gain and obesity are important risk factors for diabetes, and diabetes is also linked to several inflammatory and cardiovascular diseases, including hypertension and dyslipidemia.

 

Maintaining a healthy weight is as important as controlling the blood glucose level for people with diabetes.” He added, "I would say Mounjaro is a good option for people with diabetes who are struggling with weight control, as the drug has been clinically proven to help them lose weight." ” Mounjaro will rise as a game changer if it also demonstrates cardiovascular benefits" Currently, some diabetes drugs are expanding their area after demonstrating cardiovascular benefits.

 

SGLT-2 inhibitors, for example, are approved for heart failure and chronic kidney disease.

 

The SURPASS-CVOT clinical trial is also underway for Mounjaro to evaluate the drug’s cardiovascular benefits.

 

It has enrolled more than 13,000 adult diabetes patients with comorbid cardiovascular disease.

 

Dr.

 

Forst expects Mounjaro to become a game-changer if it proves to be effective in cardiovascular disease.

 

"We will have to wait for the results of the ongoing studies that have cardiovascular events as an endpoint, but if Mounjaro proves to be more effective than GLP-1 receptor agonists in reducing cardiovascular events, I am confident that Mounjaro will be a game-changer,” said Dr.

 

Forst.