As researchers work to test whether Novo Nordisk (NYSE:NVO)'s fat-busting drug Wegovy can also be used as a treatment for dementia and alcohol addiction, some analysts are pointing to a potential "paradigm shift" in the way obesity is treated.
Last week the Danish drugmaker, which is listed in Copenhagen and New York, briefly became Europe’s largest company as investors continued to pile in following the initial data of its 'SELECT' trial of a once-weekly injection of Wegovy.
Since the start of August, shares in Novo have jumped almost 30%, with the trial indicating that not only can Wegovy (and by implication its Ozempic sister drug) trim the waistline but cut the risk of heart attack or stroke by a fifth.
Following the initial data, excitement has been building about not only the potential size of the market for an effective weight loss drug, as well as the possibility Wegovy, Ozempic and rival drugs like Eli Lilly’s Mounjaro could be "wonder drugs" treating a range of other widespread problems.
The detailed results from the SELECT trial will be presented at the American Heart Association (AHA) meeting on November 11-13, 2023.
A bigger obesity market than expected
That release, analysts at Deutsche Bank said, could mark "the beginning of a paradigm shift" in the way that obesity and cardiovascular disease is treated.
They see physicians "moving to a weight centric treatment of multiple co-morbidities associated with obesity which we expect to lead to substantial demand for obesity treatment".
As a result, the bank increased its forecasts for the overall obesity market and now see global sales of US$71 billion by 2032, which is more than two times its previous peak sales forecast of US$34 billion.
Novo and Lilly are expect to share the bulk of this market, the bank estimates, around 90%.
In the long term Novo is seen capturing circa 45% of the market, equating to circa US$33 billion of sales potential in 2030 and 2032.
Reflecting these increased obesity market prediction, Deutsche upgraded its earnings forecasts for Novo by between 5% and 23% from 2024-2030.
Novo is seen growing at a 19% compound annual growth rate between 2024 and 2027, more than double the sector at 9%.
How Wegovy and other similar drugs work
Obesity is a major risk factor for cardiovascular disease, the leading cause of death worldwide, but for those who like to medicate to dissipate there are few effective and safe treatments.
Wegovy and Ozempic, the brand names for drugs that include semaglutide, have shown promising results, including Novo's large SELECT clinical trial.
Wegovy, a once-weekly injection, and Ozempic belong to a class of drugs called GLP-1 receptor agonists, which mimic the action of a natural hormone that regulates appetite and blood sugar levels.
Wegovy is already approved by the US FDA and other regulatory agencies for chronic weight management in adults with obesity or overweight who have weight-related health problems. It has been shown to help people lose up to 15% of their body weight in one year when combined with diet, physical activity, and behavioural support.
Other applications for Wegovy?
Researchers are also examining whether Wegovy and its peers can also prevent cardiovascular complications in people with obesity and established cardiovascular disease.
This is was the question the SELECT trial aimed to answer, enrolling 17,604 adults aged 45 years or older with a body mass index (BMI) of at least 27 kg/m2 and a history of cardiovascular disease, such as coronary artery disease, peripheral artery disease, or stroke.
The primary endpoint of the trial was the occurrence of major adverse cardiovascular events (MACE), defined as cardiovascular death, non-fatal heart attack, or non-fatal stroke.
The trial was stopped early after an interim analysis showed that Wegovy significantly reduced the risk of MACE by 20% compared to placebo, meaning for every 100 people treated with Wegovy for five years, six fewer people would experience a MACE.
When are full SELECT results being released?
The detailed results from the SELECT trial will be presented at the American Heart Association (AHA) meeting on November 11-13, 2023.
These results are expected to provide more information on the effects of Wegovy on other outcomes, such as mortality, blood pressure, cholesterol, glucose metabolism, body weight, and kidney function. They may also shed light on the mechanisms by which Wegovy exerts its cardioprotective effects.
The findings from SELECT are hoped to spell positive news for Wegovy and other drugs like it, such as Ozempic (semaglutide 1 mg) and Liraglutide (Victoza), which are also GLP-1 receptor agonists.
These drugs are currently used mainly for treating type 2 diabetes, but they may have potential applications for other conditions, such as dementia and alcohol addiction, with a lot more research needed to confirm their efficacy and safety in these settings.
Martin Holst Lange, executive vice president for development at Novo Nordisk (NYSE:NVO), said: “SELECT is a landmark trial and has demonstrated that semaglutide 2.4 mg has the potential to change how obesity is regarded and treated.”