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Viral weight loss drug linked to pancreatitis


Michelle Wisbey


6/10/2023 4:07:55 PM

Semaglutide could be putting patients at greater risk of severe gastrointestinal complications when used for obesity management.

Semaglutide packet.
Earlier this year, the TGA recommended semaglutide supplies be reserved for those who have no other treatment options available to them. (Image: AAP)

It is the weight loss trend that has spread across the globe, but for the hundreds of thousands of people taking semaglutide (sold as Ozempic), it could be causing debilitating side effects.
 
New research, published in JAMA Network on Friday, has shined a spotlight on the drug’s dangers when used for an off-label purpose.
 
It comes as Australia battles through a long-lasting semaglutide shortage, causing supply issues for patients with diabetes.
 
A team of international researchers have now found non-diabetic patients taking glucagon-like peptide-1 receptor agonist (GLP-1 RA) drugs are at a higher risk of stomach paralysis, pancreatitis, and bowel obstructions, compared with those taking other weight loss medications.
 
The research examined 4144 liraglutide (sold as Saxenda) users, 613 semaglutide users, and 654 people using the weight loss drug bupropion-naltrexone. 
 
Of those using semaglutide or liraglutide, 73 had pancreatitis, 73 had bowel obstruction, and 70 had gastroparesis.
 
For the patients using bupropion-naltrexone, just one had pancreatitis, two had bowel obstruction, and three had gastroparesis.
 
And although these adverse outcomes were rare, this ‘must be considered by patients who are contemplating using the drugs for weight loss because the risk–benefit calculus for this group might differ from that of those who use them for diabetes,’ the study concluded.
 
But Dr Georgia Rigas, former Chair of RACGP Specific Interests Obesity Management, said the research should be interpreted ‘with caution’, adding that prescribers can help to reduce negative outcomes by providing patients with a list of symptoms to look out for and how to respond if they develop.
 
‘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,’ she said.
 
‘Patients considering starting anti-obesity treatment should have an in-depth assessment and subsequent discussion with a doctor experienced in managing people living with overweight/obesity so that any recommendations are tailored to the patient's individual health profile.
 
‘The key is patients need to be informed of what the medical evidence tells us, have to put it into context, with a goal to assist them in making an informed decision.
 
‘As the incidence of these complications is low, we can still prescribe as is clinically indicated; however, as with all prescribed and over the counter preparations, we still need to remain vigilant.’
 
The research comes just weeks after the Therapeutic Goods Administration (TGA) issued firm advice not to initiate semaglutide prescriptions without a compelling clinical reason.
 
Its usage skyrocketed after becoming a social media weight loss sensation, leading to a severe shortage expected to continue well into next year.
 
The TGA recommends that semaglutide supplies be reserved for those who have no other treatment options available to them.
 
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diabetes obesity Ozempic semaglutide type 2 diabetes


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