Mechanism of Action: These agents work to increase glucose-dependent insulin secretion, decrease the rate of gastric emptying, decrease glucagon secretion, and act in certain parts of the brain to help regulate appetite.
Brand Names:
- Semaglutide Ozempic®, Wegovy®
- Tirzepatide Mounjaro®, Zepbound®
Current FDA Labeled Indications:
- Type 2 diabetes mellitus treatment Ozempic®, Mounjaro®
- Chronic weight management Wegovy®, Zepbound®
- To reduce the risk of major cardiovascular events including heart attack and strokes in patients who are overweight/obese with cardiovascular disease
Patients are eligible for semaglutide (Wegovy®) and tirzepatide (Zepbound®) indicated for weight loss if they have a BMI ≥30 kg/m2, or ≥27 kg/m2 with at least one comorbid condition relating to weight such as hypertension or dyslipidemia. Semaglutide was approved in pediatrics ages 12 years and older who have a BMI ≥95th percentile based on age and sex.
Off-label Indication: *Semaglutide only*
- Nonalcoholic steatohepatitis (NASH) – benefits seen in patients with or without type 2 diabetes mellitus
Areas of Research for Further FDA Indications of GLP-1 Receptor Agonists:
Glucagon-like peptide-1 agonists, commonly known as GLP-1’s, have been proven to lower the rate of cardiovascular death, myocardial infarctions, strokes, and all-cause mortality in individuals diagnosed with type 2 diabetes mellitus. Most recently, their use has been extended to patients with obesity who are trying to manage their weight. GLP-1 receptor agonists have been increasingly useful drugs, with further research being done to determine further FDA indications. Areas of research include some of the following:
- Neurodegenerative diseases/Alzheimer’s disease: possible protection of brain cells and improvement in cognitive function; there may be neuroprotective effects seen with a reduction in oxidative stress as well as anti-inflammatory effects
- Polycystic ovary syndrome (PCOS): may show benefits in PCOS by increasing insulin sensitivity and regulating ovulation
- Diabetes prevention: may be useful in preventing diabetes rather than just treating it
- Gastrointestinal disorders: GLP-1’s may find a role in the treatment of IBS (inflammatory bowel syndrome) as well as IBD (irritable bowel disease)
- Psychiatric disorders: may have an impact on mood disorders and cognitive function due to the metabolic influence on the brain
- Substance use disorder/addiction: may show benefit in patients who struggle with alcohol addiction and abuse of substances such as cocaine
- Chronic kidney disease (CKD): may slow the progression of CKD as well as improve renal function in those already diagnosed with CKD
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This Post Was Written By:
Cara Daidone, PharmD Candidate 2025
