Ozempic is much more than a weight-loss drug, studies show

Ozempic and similar new diabetes drugs are very likely to improve heart and kidney health for sufferers, research is revealing. But Australia’s supply shortage will not be resolved this year.

New research from Sydney’s George Institute for Global Health and Royal North Shore Hospital suggests Ozempic can be safely used alongside existing treatments to reduce heart and kidney complications.

Colleen Alexander has taken medication for type 2 diabetes for years. Credit: Dominic Lorrimer

The paper, published in The Lancet Diabetes & Endocrinology last week and presented at the European Renal Association Congress, analysed data from more than 72,000 patients worldwide.

It found no increase in adverse events when combining newer diabetes drugs known as GLP1-RAs, such as semaglutide (sold as Ozempic), with older medications, known as flozins.

George Institute Clinical Associate Professor Brendon Neuen said the analysis showed that combining the treatments was a valid course of action.

“There has been a lot of interest in using them in combination, but we haven’t had the data to support that until now,” he said.

Because the two classes of drug work in different ways – GLP1-RAs enhance insulin release and sensitivity, while flozins lower blood glucose by increasing its excretion in urine – Neuen said it was considered very likely that combining the drugs improved effectiveness.

“The way we are interpreting this is, it is very likely to provide additive protection,” he said.

The new research follows the highly anticipated results of the international FLOW trial, a large-scale clinical trial that suggested a weekly dose of semaglutide reduced risk of major kidney failure in people with type 2 diabetes and chronic kidney disease by 24 per cent.

University of Sydney diabetes researcher Professor Stephen Twigg, who was not involved in either of the recent papers, said there was a “rich tapestry” of research coming through in the field.

“There are studies showing these drugs have been good at preventing some major health outcomes that we may not have been predicting,” he said.

Twigg said the next steps should be to assess the cost-effectiveness of such treatment – weighing up the price of subsidising expensive medications against the saving they could provide for the health system – and to examine whether different drugs performed better for different people.

So-called “personalised” or “precision” medicine is a booming field in oncology, where genetic testing is increasingly guiding cancer treatments.

“But in personalising care for diabetes, we are still learning about sub-groups of patients and how we can best target interventions,” Twigg said.

“As more evidence becomes available, we are getting a better feel for which medicines are going to be more effective.”

Neuen said further research should look at whether combining flozins with GLP1-RAs was effective in people who do not have type 2 diabetes.

Ozempic has been in short supply in Australia since 2022, when its popularity skyrocketed as social media videos credited the drug for rapid weight loss. Due to demand, people with type 2 diabetes complained pharmacists were struggling to fill their scripts.

The Therapeutic Goods Administration then discourage GPs from prescribing it off-label for weight loss.

The latest advice from the drug’s manufacturer, Novo Nordisk, is that supply will remain limited throughout 2024. The TGA has also cracked down on compounded versions of the drug, due to quality control concerns.

Type 2 diabetes patient Colleen Alexander has taken a flozin for several years. Having lost half a kidney to cancer, the 82-year-old from Gladesville, in Sydney’s north, said she would be discussing her ongoing treatment options with her doctor.

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