U.S. Eli Lilly, competing with Denmark's Novo Nordisk over obesity treatments, noted it would be the first in the industry to develop medications for treating drug addiction, including alcohol and nicotine. Since obesity stems from food addiction, it aims to treat other substance addictions with ingredients from obesity medications. Recently, clinical trial results showed that Eli Lilly's obesity drug, Zepbound, had greater weight loss effects than Novo Nordisk's Wegovy, indicating a strategy to lead in both the obesity drug market and the field of substance addiction treatment.
David Ricks, the CEO of Eli Lilly, said in an interview with Bloomberg on Oct. 10 (local time), 'Medications in the glucagon-like peptide (GLP)-1 class, including Zepbound, can reduce cravings for food as well as suppress desires for other substances,' and he added, 'We will begin large-scale research for developing treatments for alcohol, nicotine, and opioid abuse starting next year.'
This study will utilize orforglipron, an oral obesity drug currently under development by Eli Lilly. The company is conducting Phase 3 clinical trials for orforglipron worldwide, including in South Korea and the United States. It has already demonstrated an average weight reduction effect of up to 14.7% through Phase 2 trials.
The human GLP-1 hormone regulates neurons in the hypothalamus of the brain, reducing appetite after meals and inducing a feeling of fullness. This principle was mimicked in GLP-1 analogs. Recent scientists have predicted that targeting the entire brain using the principles of GLP-1 could yield numerous other effects. Recently, GLP-1 analogs were found to be associated with reductions in opioid use disorders. Wegovy has also been confirmed to show therapeutic effects not only for obesity but also for substance addiction and neurodegenerative diseases such as Alzheimer's.
Earlier, a research team at Loyola University in Chicago announced in October that Ozempic, a diabetes treatment with the same ingredients as Wegovy, reduced drug and alcohol addiction by nearly half. In a study involving 503,747 individuals with histories of opioid use disorder (OUD) and 817,309 with histories of alcohol use disorder (AUD), the results indicated that patients prescribed Ozempic had an average 40% lower overdose rate compared to other patients.
Opioids include narcotic drugs such as morphine, heroin, methadone, fentanyl, and oxycodone. They are primarily used to alleviate postoperative pain; however, overdoses have become one of the leading causes of death among individuals aged 25 to 54 in the United States, coining the term 'opioid crisis.' According to the U.S. Department of Health and Human Services (HHS), the number of deaths due to opioids in the U.S. exceeded 81,000 last year.
As the demand for treatments for narcotic drugs is high, Eli Lilly plans to be the first in the industry to begin clinical trials using GLP-1 analog drugs. While its diabetes and obesity drug development is one to two years behind Novo Nordisk, the strategy suggests that the company aims to take the lead in the field of substance addiction treatment. Novo Nordisk's Ozempic and Wegovy received approvals in the U.S. in December 2017 and July 2021, respectively, while Eli Lilly's diabetes drug, Mounjaro, was approved in May 2022, and the same ingredient's Zepbound was approved last November.
There are analyses indicating that Eli Lilly's recent announcement was also driven by its decisive victory in the obesity drug efficacy trials. On the 4th, Eli Lilly noted that Zepbound led to a weight loss effect that was 47% greater than that of Wegovy in clinical trials on obesity patients. This was the first time the two obesity treatments were directly compared in the same patient cohort.
Novo Nordisk is also keeping a close watch on the field of substance addiction treatment. It was previously announced that in a smaller clinical trial conducted by Novo Nordisk, semaglutide, an ingredient of Wegovy, was found to treat individuals addicted to opioids. However, it became known that more than half of the participants dropped out due to side effects during the three-week test, revealing the need for additional research. Furthermore, although Novo Nordisk recently began clinical trials of GLP-1 class drugs for alcohol-related liver disease, a U.S. medical journal, STAT, assessed that this is more of a supplementary measure rather than a primary endeavor in addiction treatment.
Eli Lilly has now taken a lead in developing treatment for substance addiction, but it still has a long way to go. Allison Shapiro, a professor at the University of Colorado, noted, 'GLP-1 analog obesity drugs will likely affect not only hunger, body temperature, and heart rate but also taste and reward systems in the hypothalamus and hindbrain.' This, she suggested, could potentially reduce symptoms of drug or alcohol addiction. However, the exact mechanisms remain to be elucidated.
Ultimately, Eli Lilly, as the frontrunner, faces the challenging task of clarifying these mechanisms. Ricks, the CEO of Eli Lilly, said, 'Conducting clinical trials of GLP-1 class drugs for developing treatment for substance addiction is the first such initiative among major pharmaceutical companies in the world.' He added, 'No pharmaceutical company has previously tested specific treatment methods for addiction, and that's what we aim to accomplish.'