The list of uses for GLP-1 agonist drugs is growing: it started as a treatment for type 2 diabetes, then was promoted as a weight-loss drug.
There is also evidence that GLP-1 agonists, such as semaglutide and tirazepate – sold as Monzaro, Ozempic, Vegovy, and Zepound –
- Reduce the risk of cardiovascular diseases
- Protect kidney and liver,
- reduce swelling and pain,
- Prevent addiction and substance abuse,
- Help people with arthritis
- And those who have sleep apnea.
Take the view from 30,000 feet, and you’ll see a classic case of what is known in this business as drug repurposing. It is a medicine with many uses.
Repurposing medicines in health crisis
What may seem to some people as a clever way to cash in on an already popular drug is, for others, a cost-effective, time-efficient way to save lives.
The COVID-19 pandemic is an example: consider the drugs dexamethasone and baricitinib.
When Covid arrived, dexamethasone and baricitinib were already there. They are used to treat swelling (inflammation).
Dexamethasone has wide applications – it can be used for arthritis, asthma, blood or bone marrow problems, kidney problems, skin conditions and acute cases of multiple sclerosis.
Baricitinib is used to treat moderate to severe rheumatoid arthritis, moderate to severe atopic dermatitis, and severe alopecia areata, an autoimmune disease that attacks the hair (it causes hair loss).
And then doctors tried these drugs to treat inflammation in COVID patients — this was in the first and early stages of COVID vaccines.
In 2021, the UK National Health Service reported that dexamethasone saved the lives of 22,000 people in the UK and an estimated one million worldwide.
Meanwhile, baricitinib controls elevated cytokine levels and inflammation. During Covid, doctors and researchers observed “cytokine storm” in patients – when the immune system becomes overactive, which ultimately causes severe inflammation.
Following these experiences during COVID, the European Commission plans to increase support for drug repurposing to discover cancer cures.
A health warning on reused drugs
None of the above should be read to suggest – and this is not a recommendation by DW – that anyone should use GLP-1 agonists, or any other medications, to treat any “off label”/non-approved condition without personal, professional medical advice. There are risks with the use of any drug, and for example, as the use of GLP-1 has increased, lesser known risks have also emerged.
It should also be no surprise that GLP-1 agonists have such universal health benefits.
If drugs can help you lose weight, or prevent it from gaining weight, reduce addiction, they will also reduce the risk of type 2 diabetes – which is largely caused by “lifestyle choices” such as overeating – and in turn, reduce the stress on every organ of the body.
It’s almost as if the original developers of the first GLP-1 agonists planned a series of sequels—they didn’t invent drug repurposing.
But – as we saw above – drug re-use is usually done accidentally or in a moment of great desperation, such as the COVID-19 pandemic.
A Brief History of Drug Repurposing
The following list is by no means exhaustive. Perhaps it can be best read as an illustration of the interconnectedness of the human body – that we are a system, and therefore, it is reasonable that a medicine can have multiple uses.
In cancer treatment, there are two notable examples – the first being the drug raloxifene. Raloxifene was originally developed to treat osteoporosis.
Then, a large study in 25 countries showed its potential for re-use in people at high risk of breast cancer. In the study, the risk of invasive breast cancer was reduced by 76% during three years of treatment in postmenopausal women with osteoporosis. The US Food and Drug Administration (FDA) – considered the world standard on drug and vaccine approval – has approved raloxifene for the prevention of aggressive breast cancer.
Thalidomide – a drug perhaps better known for its controversial history in the 1950s as a sedative for pregnant women with morning sickness, which was withdrawn after being found to cause serious skeletal birth defects – was repurposed and approved by the FDA nearly 60 years later for use in combination with dexamethasone in patients with newly diagnosed multiple myeloma. Multiple myeloma is an incurable but treatable blood cancer.
More recently, there have been studies repurposing drugs for Alzheimer’s disease, a form of neurodegeneration or dementia. The prevalence of dementia is increasing rapidly.
A 100-year-old vaccine against tuberculosis, called Bacillus Calmette-Guerin, controls blood sugar in people with type 1 diabetes – and, therefore, controls the need for insulin.
But perhaps the most famous – or infamous – case of drug abuse is that of Viagra, or sildenafil.
This medication was originally developed to treat heart-related conditions such as chest pain or angina. Then it was found – to make a long story short – to help men with erectile dysfunction. And it later became known as the “little blue pill”.
Another warning – this time from history
Writing in the British Medical Journal in 1998, Abi Berger, a general practitioner, said: “This must surely be every pharmaceutical company’s dream: to make a product so sexy that the need for marketing and public relations disappears because of the tidal wave of media publicity.”
It is as if the hype surrounding GLP-1 agonists is a case of “history repeating.”
So, let’s end on a note of history: Not only did the publicity put pressure on the production of sildenafil back in the day, but recent studies have also found it to cause abnormal heart rhythms.
And the same may be true for GLP-1 agonists: evidence of their reuse – their real benefits and harms – may only be seen over many years’ time.
Edited by: Jakov Leon