(Reuters) – (This is an excerpt of the Health Rounds newsletter, where we present latest medical studies on Tuesdays and Thursdays)
The usual dose of Novo Nordisk’s expensive weight-loss drug Wegovy can be cut in half without affecting the results, researchers reported on Tuesday at the European Congress on Obesity in Malaga, Spain.
They tracked nearly 2,700 participants in an employer-sponsored weight-loss treatment program who were receiving the GLP-1 drug semaglutide – the main ingredient in Wegovy and Novo’s diabetes drug Ozempic.
Patients experienced as much weight loss as was seen in earlier clinical trials, but with half the dose, the researchers said.
During the 64-week study, participants lost an average of 16.7% of their body weight on a mean dose of just 1.08 milligrams of semaglutide per week, substantially lower than the typical 2.4 mg dose.
This was true regardless of body mass index at the start.
Nearly 98% of participants lost at least 5% of their starting body weight, a threshold widely recognized as clinically meaningful. Many kept the weight off even after stopping the medication.
As GLP-1 use grows and employers’ insurance plans need to adapt to the costs, “the study points to a path toward meaningful outcomes without escalating drug costs,” the researchers said in a statement.
Some analysts have forecast sales of newer weight-loss drugs reaching $150 billion a year in the next decade.
Embla, the Danish digital weight loss clinic that led the program, uses a treat-to-target protocol that holds doses steady when patients are progressing, with fewer than 30% of users escalating beyond 1 mg per week.
“When care is designed around the patient, lower doses often prove sufficient,” Nicholas Syhler, Embla co-CEO, said in a statement.
A report of the study by Soren Seier and colleagues at the University of Copenhagen is awaiting peer review.
RESEARCHERS FIND NEW CLUES TO DIABETIC NERVE PAIN
Researchers have identified a potentially crucial component of diabetic nerve pain that could lead to new treatments for the debilitating condition, they reported in Nature Communications.
“Treatment options are not great, and if the underlying diabetes is not managed, people may require amputation due to damage to the peripheral nerves to the point of loss of sensation,” study leader Stephanie Shiers of The University of Texas at Dallas said in a statement.
In tissue samples from patients with diabetic neuropathy, the researchers found Nageotte nodules, which are dead sensory nerve cells that have decayed, inside clusters of nerve cells called sensory ganglia.
The nodules “appear to be a sign of degeneration” resulting from damage caused by high blood sugar levels, Shiers said.
The finding that Nageotte nodules are a strong indicator of nerve cell death in human sensory ganglia suggests they could become a target for drugs that would protect the nerves or help manage diabetic neuropathy.
“In my view, one of the most important insights we gained from this work is thinking about treating diabetic neuropathic pain differently,” senior author Dr. Ted Price of The University of Texas at Dallas said in a statement.
“I think what we need to focus on now is neuroprotection at early stages of disease so that these Nageotte nodules do not form in the first place.”
BREAST TISSUE TRAITS HELP PREDICT CANCER RISK
Women with any of six different breast tissue textures may be at higher risk for breast cancer, researchers reported on Tuesday in Radiology.
The researchers used computer algorithms to analyze mammograms of more than 30,000 women without breast cancer, looking for patterns and characteristics that might not be visible to the human eye. They identified six sets of characteristics and then looked at a further set of mammograms from another 3,500 women.
The sets of traits, or phenotypes, were associated with a higher risk of invasive breast cancer in both Black and white women — although it was higher among Black patients — as well as a higher risk of having a cancer missed on a mammogram or developing a cancer in between scheduled routine mammograms, the researchers said.
“Breast cancer tends to be more aggressive in Black women, highlighting the need for novel risk factors in this population,” co-senior author Despina Kontos of Columbia University Irving Medical Center.
In a separate study, researchers at the National Cancer Institute identified a series of changes in the architecture and cell composition of connective tissues of the breast, known as stromal tissue, associated with an increased risk of developing aggressive breast cancer among women with benign breast disease, and poorer rates of survival among women with invasive breast cancer.
The changes, which they call stromal disruption, could potentially be used as a biomarker to identify women with noncancerous lumps, cysts, and other changes in breast tissue who are at high risk of developing aggressive breast cancers, as well as those with breast cancer who may be at increased risk of recurrence or death, the researchers said in a report to appear on Wednesday in The Journal of the National Cancer Institute.
They used machine learning to detect subtle changes in the stroma of 4,023 donated samples of healthy breast tissue, 974 biopsies of tissue with benign breast disease, and 4,223 biopsies of tissue with invasive breast cancer.
(Reporting by Nancy Lapid; editing by Bill Berkrot)
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