The drugs on the market that will change everything
Also, have we cracked Long COVID? The biodiversity hotspot under our feet. Plus, an Australian medical mystery.
Something really life-changing is happening right now. And I’m not talking about AI, the pandemic, the microbiome, or climate change right now. These are topics I cover regularly in this newsletter, but there’s something else that you need to know - that might affect your own life and that of those you love in a positive way.
You may have read about how Nvidia is providing the essential “picks and shovels” needed for the AI gold rush. There’s another company in another sector, healthcare, that is captivating the stock market.
Earlier this week, Eli Lilly's stock shot up by 17% to reach an all-time high. Why? Sales of just one drug have ballooned by more than 70% since the first quarter to a whopping $980 million. The experts were caught off guard. They expected the drug to bring in about $740 million during the quarter, but obviously it exceeded those expectations by a wide margin.
Yesterday, a flurry of analysts increased the price target for Eli Lilly and upgraded the stock.
The last such frenzy occurred during the height of the pandemic of course, when Pfizer and Moderna shot to the roof with their effective and safe COVID-19 vaccines and boosters. But Moderna’s stock has since done a roundtrip because sales of the vaccine has not kept up and for most people the pandemic is mentally over. Eli Lilly’s has more staying power. I’ll get to why in a minute.
I’ve not seen much mention of this in the Indian press. But part of this is understandable. Almost all of the money that Eli Lilly is minting is coming from sales within the U.S.
So what’s the big deal? And what does it mean for you?
First off, it should be obvious that this newsletter - or any newsletter - can only be educational and not provide medical advice. You should always see a doctor if you have concerns about your own health. Now with that out of the way…
I wrote about how new drugs initially meant to treat diabetes have had oversized effects on obesity. You can read my column here, but here’s the gist.
Obesity is an Epidemic:
Many people in my own family struggle with weight and obesity.
Obesity isn't just about appearance or poor food choices. It's a complex biological disease with roots in lifestyle, genes, metabolism, poverty, and structural inequalities, leading to health issues like heart problems and type 2 diabetes.
Obesity in India:
A concerning rise in obesity is reaching "epidemic proportions" in India. By 2040, the prevalence of being overweight could double, and obesity might triple among Indian adults aged 20–69.
If obesity is a disease, there should be a cure. Excitingly, the day might be approaching when obese individuals could benefit from weekly injections or daily pills to shed those extra kilos.
New Obesity Drugs:
The biomedical community is buzzing about a new class of obesity drugs like Semaglutide, tirzepatide, orforglipron, and retatrutide, with the first two already approved for global use.
Recent studies show that these drugs' results are nothing short of spectacular, offering hope for significant weight loss.
How they work:
These drugs mimic hormones that regulate blood sugar and were unexpectedly found to cause weight loss, like GLP-1, which reduces appetite and slows digestion.
First Success with Liraglutide: Liraglutide was one of the first GLP-1 drugs that had an effect on body weight. Tweaking it led to Semaglutide (Ozempic and Wegovy), which allowed an average 15% weight loss over 68 weeks.
Tirzepatide's Extra Trick: Next came Tirzepatide (Mounjaro), a more potent version that acts like two hormones, leading to a 21% reduction in body weight.
Triple Action with Retatrutide: Retatrutide takes it further with three hormones, leading to a 24% average weight loss, previously unimaginable without surgery. This drug is still in trials.
Orforglipron - A Pill Option: Orforglipron is in trials as a daily pill, which might help people lose 9% to 15% of body weight, making it possibly more accessible due to its form and price.
Limitations and Side Effects:
The downsides include unknown long-term requirements, common side effects like nausea, and the fact that these drugs don’t work for everyone. The future might bring modified versions to mitigate side effects and better knowledge about who might benefit most from these drugs.
Without lifestyle changes, ceasing treatment may lead to weight regain, pointing to the importance of a comprehensive approach.
The biggest challenge remains accessibility and affordability, with shortages already occurring in some countries, a critical issue for populous regions like India.
Why This Matters to You
Just a few days ago, in my column I wrote that these new obesity drugs have vast potential, not only for weight loss but also for overall metabolic health improvement, including heart health.
And quite remarkably, recent study showed that one such drug by Novo Nordisk helps reduce the risk of heart problems in overweight adults. This is great news not only for Novo Nordisk but also for their rival, Eli Lilly.
The study aimed to find out if losing weight with the Novo Nordisk obesity drug could lower risks like heart attacks. The study showed a 20% drop in heart problems for a medicine not developed to treat heart disease.
Now, here's why you should care: Treating obesity with prescription drugs has been a hot debate. Some insurance companies haven't wanted to cover obesity treatments because they saw it as a "lifestyle" issue, similar to quitting smoking. This means that many patients had to pay for their medicines themselves. But this new success could change the way people see obesity treatment. It could lead to more support and coverage for these essential medication in the US.
Have we cracked Long COVID?
In a new study published in Science Translational Medicine, researchers have mapped how the SARS-CoV-2 virus disrupts mitochondria, the energy-producing structures in cells. This damage could explain many persistent symptoms of long COVID, such as fatigue and brain fog.
Unlike previous theories centered on inflammation or collateral immune damage, this research emphasizes the genetic mechanism that the virus uses to damage mitochondria across organs like the lungs, heart, liver, kidneys, and brain, leading to more severe disease.
Led by Douglas Wallace, the research team examined nasopharyngeal swabs and autopsies to discover how the virus inhibits genes vital for energy production. Astonishingly, the virus used an alternative approach that it then leveraged for its own replication, similar to cancer cells.
“She invited four people over for lunch. A week later, three were dead.”
In a mysterious case that reads like a thriller, three people have died in a suspected poisoning after a lunch at a country home in Victoria, Australia. Two couples, pillars of their tight-knit rural community, were invited to the gathering. After the meal, all became seriously ill, and three later died, with one man still critically ill. The host and her children were unharmed. Police suspect the poisoning may be linked to death cap mushrooms, one of the deadliest to humans. The host was questioned but released without charge, and several items have been seized for investigation, including a food dehydrator found at a landfill. The deaths are unexplained, and the authorities are keeping an open mind, acknowledging that it could be an innocent case of mistaken identity with the mushrooms.
The biodiversity hotspot under our feet.
According to a study published in the Proceedings of the National Academy of Sciences, soil is the single most species-rich habitat on Earth, home to an estimated 59% of all life. This figure doubles previous estimates from 2006, revealing that soil houses 90% of fungi, 85% of plants, and over 50% of bacteria, making it a crucial area for biodiversity. The findings emphasize the importance of soil, not just for growing 95% of the planet's food but also for its impact on climate change, global food security, and human health. Despite its significance, soil has often been overlooked in discussions about nature protection, and the study’s large error range of 15% highlights the need for more research.
That’s it this week. Next week I might talk about room temperature superconductivity. Just kidding. I’m not a physicist or materials science expert so I will let this play out before commenting.
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Stay cool!
Anirban