Health Rounds: Lilly's Mounjaro tops other GLP-1s for some type 2 diabetes patients

Eli Lilly and Company

Eli Lilly and Company

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By Nancy Lapid

- Hello Health Rounds readers! Today we highlight another study of GLP-1 drugs, this time for type 2 diabetes patients who were not responding well to standard initial treatment. We also report on two studies with findings that could bring eventual relief for patients still struggling with long COVID symptoms.


Early use of Lilly GLP-1 Mounjaro shows advantages in type 2 diabetes

Recently diagnosed type 2 diabetes patients who did not respond well to a usual first-line treatment fared better after adding Eli Lilly's LLY.N GLP-1 tirzepatide than with the addition of other drugs in the class, a study funded by the company found.

Tirzepatide is sold under the brand name Mounjaro for diabetes in the U.S. and for both diabetes and obesity in other countries.

In the SURPASS-EARLY trial, nearly 800 adults diagnosed with type 2 diabetes within the past four years whose disease was not adequately controlled with metformin, diet and exercise were assigned to add either tirzepatide or other medications.

Most patients in the control group received other GLP-1 drugs such as semaglutide, which Novo Nordisk NOVOb.CO sells for diabetes as Ozempic or Rybelsus, or Lilly's Trulicity (dulaglutide).

Two years later, patients receiving the weekly tirzepatide injections had greater improvements in blood sugar control as reflected by hemoglobin A1c level, and in weight and waist circumference, compared to patients in the control group.

Furthermore, roughly 60% of participants receiving tirzepatide had achieved normal blood sugar levels after two years, compared to 24% of patients in the control group, according to a report of the study published in Annals of Internal Medicine.

The findings suggest that starting tirzepatide earlier if standard care is inadequate may provide stronger and more sustained metabolic benefits than other standard approaches, the researchers said in a statement.


Immune system may cause long COVID neurological symptoms

The debilitating neurological symptoms of long COVID are often due to the body's mistaken attack on itself, according to discoveries from two studies that could lead to effective treatments for the condition and changes in blood donation policies.

In both studies, researchers collected so-called autoantibodies in blood from volunteers with long COVID. Normally, the immune system's antibodies defend the body from attack, but autoantibodies – commonly seen after acute viral infections and persisting during long COVID - attack the body by mistake.

When the human autoantibodies were infused into healthy mice, the mice developed neurological features mimicking those of the patients, including fatigue, loss of balance, pain sensitivity, and nerve fiber damage.

In one experiment, the effect was reproduced even when the autoantibodies were collected from patients two years after the initial infection, according to a paper in Cell Reports Medicine.

“This new awareness of the physiology of long COVID will enable us to identify a number of effective treatments for autoimmunity that could significantly improve the symptoms of millions of people with this chronic condition,” Dr. David Putrino from the Icahn School of Medicine at Mount Sinai, New York, and a coauthor of a separate study published in Cell, said in a statement.

“Before we had no way of predicting who would benefit from (existing) therapies,” he said. “Our study now shows that if you are in a subgroup of long COVID patients who have autoantibodies circulating in your body... you may be a good candidate for these drugs.”

A commentary in Cell said the two studies “provide compelling evidence that autoantibodies directly contribute to symptom generation in a subset of people with long COVID," but neither study provides definitive proof of a single, central mechanism behind the condition.

In addition to their clinical significance, Putrino believes the findings carry an urgent public health warning regarding blood donation.

“In the UK, having long COVID is an exclusion for donating blood, while in the United States these individuals are still allowed to donate,” he said.

“Given the dangers that (autoantibodies in) plasma from people with long COVID can pose for others, this country should be considering fundamental changes to its donation policies.”