Anvisa (National Health Surveillance Agency) approved the first injectable drug for weekly use for overweight and obesity. The decision was published in the Official Gazette this Monday (2).
Called Wegovy (2.4mg semaglutide), the injection is produced by the pharmaceutical company Novo Nordisk and has the same active principle as the drug Ozempic, indicated for type 2 diabetes and which already has approval in Brazil.
Semaglutide performs some actions in the body that help with weight loss. One is to increase feelings of fullness and reduce appetite.
The approval was based on the results of clinical studies involving more than 4,500 people worldwide. The medicine led to an average reduction of 17% of body weight in patients in about 17 months – 1 in 3 study participants lost 20%. Volunteers who were part of the control group, using placebo, lost only 2.4% of body weight.
In the United States, semaglutide has been approved by the American regulatory agency (FDA) since the end of 2021 and has a list price of US$ 1,349 (about R$ 6,000).
The substance became very popular on social media starting in October last year, after billionaire Elon Musk attributed his weight loss to it, and it was missing from American pharmacies.
In Brazil, there is still no set date for when the medication will arrive at pharmacies or how much it will cost. According to Novo Nordisk, it is necessary to wait for the finalization of processes, such as the definition of prices by the Medicines Market Regulation Chamber.
The medication has not yet been submitted for evaluation at Conitec (national commission for the incorporation of technologies in the SUS) for eventual offer by the public health system. Currently, the commission is evaluating the incorporation of liraglutide in the SUS, which has been approved by Anvisa since 2016.
For the endocrinologist Paulo Miranda, president of Sbem (Brazilian Society of Endocrinology and Metabology), the approval of the medication is one more tool in the arsenal of appropriate therapeutic strategies for the treatment of obesity.
“It is a drug that has shown the greatest weight loss for people with obesity, sustainably over one to two years and also safely. The diabetes studies, which are more than five years old, demonstrate cardiovascular safety and potential benefit cardiovascular.”
He reinforces, however, that changes in life habits remain the basis for any weight loss proposal, since weight regain is very frequent.
“Obesity is a highly relapsing chronic disease. Once you interrupt the treatment, it is not surprising that the person regains weight. Just as it is not surprising when a person with hypertension suspends the medication and the pressure rises again.”
For him, the most appropriate path is for patients with obesity to have individualized monitoring and strategies for maintaining the lost weight. “Some people will need to stay on medication for a long time.”
One of the major problems is access to new treatments. Currently, in SUS primary care, there are services with professionals, such as nutritionists and physical education professionals, who advise on lifestyle changes necessary for weight loss.
SUS also offers bariatric surgeries, indicated for people with severe obesity and who need to lose more than 30% of body weight. “But people who are not at these extremes, unfortunately, do not have any other strategy. There is no medication available in the SUS for the treatment of obesity.”
According to Miranda, it is important that public authorities recognize obesity as a health problem and not as a behavioral situation.
“The person with obesity is not to blame. It is important that he has multidisciplinary attention to change habits, but eventually he will need medication or surgery.”
Endocrinologist Cíntia Cecato, president of Abeso (Brazilian Association for the Study of Obesity and Metabolic Syndrome), also cites the issue of access as a major problem.
“When I look at the good results of these new substances, I know that they will help obese people to lose weight, reduce comorbidities, improve quality of life, I just keep thinking: what about our patients? This issue of access is always a dilemma”, he said. she, during Obesity Week, an event that took place last November in San Diego (California).
At the same time, doctors condemn the use of these new medications by people who don’t need them and without follow-up for weight loss.
“The person may even have some weight loss, but, without guidance, they will regain it and may still suffer from adverse effects that could be prevented with proper guidance.”
When ingested under medical supervision, the dose is gradually increased precisely to contain unpleasant sensations such as nausea, vomiting and diarrhea.
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