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A comprehensive cohort study has shed light on the benefits and risks associated with weight-loss drugs, offering valuable insights for clinical care and future research. Published in Nature Medicine on 20 January 2024, the study found the use of glucagon-like peptide 1 receptor agonists (GLP-1RAs)-used to treat diabetes and obesity-associated with a reduced risk of substance use disorders (including alcohol, cannabis, opioid and stimulant use disorders). Weight-loss drug use was also linked to decreased risks of psychotic disorders, seizures, neurocognitive disorders (including Alzheimer's disease and dementia), coagulation disorders, cardiometabolic disorders, infectious illnesses and several respiratory conditions. However, the use of GLP-1RAs was not without risks, as researchers identified an increased risk of gastrointestinal disorders, hypotension, syncope, arthritic conditions, nephrolithiasis, interstitial nephritis, and drug-induced pancreatitis associated with their use. The analysis, utilising the U.S. Department of Veterans Affairs databases, compared 215,970 GLP-1 RA users with patients using sulphonylureas (n=159,465), DPP4 inhibitors (n=117,989), SGLT2 inhibitors (n=258,614), or a composite of the three (n=536,068).

The MHRA on Wednesday granted a license for Eli Lilly's new Alzheimer's treatment, donanemab, for use in adults with mild cognitive impairment or mild dementia due to Alzheimer's disease. However, the drug will not be available on the NHS, as the National Institute for Health and Care Excellence (NICE) concluded that it "does not currently demonstrate value for the NHS." The health spending watchdog explained that the costs of providing donanemab, including regular infusions and intensive monitoring for serious side effects, outweigh the relatively small benefits it offers to patients, and so it "cannot currently be considered good value for the taxpayer." Helen Knight, director of medicines evaluation at NICE, said: "For NICE to be able to approve a medicine for use in the NHS it must provide additional benefits to patients, and it must also represent a good use of NHS resources and taxpayers' money. Donanemab (also called Kisunla) is a monoclonal antibody drug given by infusion (through a drip in the arm). It targets and reduces beta-amyloid proteins, whose abnormal buildup is associated with Alzheimer's disease.

Professor Kamila Hawthorne, chair of the Royal College of GPs, has cautioned that while weight loss drugs hold significant potential to enhance many patients' lives, they are not without risks. She also expressed concern that expanding the roll out of tirzepatide at the scale proposed by the National Institute for Health and Care Excellence (NICE) would have "significant practical and resource implications for the NHS and primary care." The final draft guidance from NICE, published on 5 December, suggests that around 220,000 people living with obesity will be offered the weekly injection, along with a reduced-calorie diet and increased physical activity, over the next three years. Marketed under the brand name Mounjaro by Eli Lilly, tirzepatide is recommended for people with a body mass index (BMI) of more than 35 and at least one weight-related illness. Accepting the request from NHS England to roll out the medication over 12 years, the NICE guidance proposes to prioritise those with the highest clinical need.