Wegovy (active ingredient semaglutide) and Manjaro (active ingredient tirzepatide), which have created a sensation in the obesity medication market worldwide, are also competing in the obesity complication market. Although Manjaro was released later than Wegovy, experts suggest it has a higher weight loss effect and is in a superior position in the secondary battle occurring in the obesity complication market.
Professor Lee Woo-jin of Seoul National University College of Medicine noted on the 14th at the 'Korean Society for the Study of Obesity Spring Academic Conference' held at the Grand Walkerhill Seoul in Gwangjin, Seoul, that 'the obesity treatment medication Manjaro appears to be as effective as surgery for treating obstructive sleep apnea (OSA) patients.'
Wegovy from Danish pharmaceutical company Novo Nordisk and Manjaro from American company Eli Lilly were both initially developed as diabetes treatments before their weight loss side effects were confirmed, resulting in their transformation into obesity treatments. Both are glucagon-like peptide (GLP)-1 class obesity treatments that promote insulin secretion while slowing the rate of food digestion in the stomach, leading to feelings of fullness and appetite suppression for weight loss effects.
The two obesity treatments have shown effectiveness for weight loss and for obesity complications such as obstructive sleep apnea, fatty liver, and cardiovascular diseases. As related research results continue to be announced, the expectations for market expansion are growing. Experts predict that following the first round battle over obesity, Manjaro is likely to continue its dominant wins in the second round of treating obesity complications.
Obstructive sleep apnea is a condition where breathing repeatedly stops during sleep, and in severe cases, patients may have to undergo a 'Beatrix surgery' to remove the stomach or small intestine, or receive 'continuous positive airway pressure (CPAP)' treatment. The medical community anticipates that obesity medications will be helpful, as 70% of patients with obstructive sleep apnea are overweight or obese.
Professor Lee Woo-jin said, 'There is research showing that administering tirzepatide to patients with severe obesity who have a body mass index (BMI) over 30 and suffer from obstructive sleep apnea has led to a 55-62.8% reduction in symptoms,' adding, 'This is similar to the level of improvement seen in patients who underwent Beatrix surgery and continuous positive airway pressure treatment.' The FDA approved Manjaro as a treatment for sleep apnea in December of last year.
Wegovy and Manjaro received approval as obesity treatments from the U.S. Food and Drug Administration (FDA) in 2021 and 2023, respectively. Wegovy is considered the originator of the GLP-1 class obesity treatments and initially led the market. The latecomer Manjaro is a dual-action agent that works with both GLP-1 and gastric inhibitory peptide (GIP), showing superior weight loss effects compared to Wegovy and currently leading in market share.
Eli Lilly announced the results of a direct comparison of the efficacy of the two obesity medications in December of last year. Patients taking Manjaro lost an average of 20.2% over a year and a half (72 weeks), while those taking Wegovy lost 13.7% over the same period. Following its superior efficacy in the primary battle of obesity, Manjaro is also emerging as a strong contender in the secondary battle against obesity complications.
Manjaro has also shown superior therapeutic efficacy for metabolic dysfunction-associated steatotic liver disease (MASH), which is a related illness commonly suffered by obese patients. MASH develops when non-alcoholic fatty liver worsens and causes liver fibrosis and functional decline. Until now, there has been no treatment for it, and only last year did the first treatment receive approval from the FDA.
Professor Lee Yong-ho of Yonsei University College of Medicine said, 'Semaglutide has also shown good effects in clinical phase 2 trials for MASH, but tirzepatide appears to have slightly better efficacy,' adding, 'Tirzepatide is also expected to be a promising treatment for MASH.'
There are also other obesity treatments under development as fatty liver treatments in Korea. Professor Lee explained, 'Research results show that serpodutide, a candidate obesity treatment being developed by German company Boehringer Ingelheim and Danish company Zealand Pharma, has also shown excellent efficacy for fatty liver, thus gaining attention.' Serpodutide is a dual-action glucagon and GLP-1 agent that received approval for clinical phase 3 trials targeting domestic MASH patients last September.