Does the popular weight loss drug semigroutide cause blindness? Novo Nordisk and Lilly panic as the 100 billion market changes

Photo source: JAMA Ophthalmology official website

Blue Whale News, February 14 (Reporter Tu Jun)GLP-1RAs are increasingly widely used in the treatment of diabetes and obesity, but their risks are also receiving increasing attention.

According to a recent article published in the JAMA Ophthalmology Trusted Source, in 2023, nearly 2% of the U.S. population will receive prescriptions for semigroutide (semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA) mainly used to treat type 2 diabetes and obesity), and there have been recent concerns that this drug and other similar drugs may be linked to ocular complications.

According to the study, nine U.S. patients developed ocular complications after taking Novo Nordisk’s Ozempic or Lilly’s Mounjaro.

Or associated with rapid blood sugar fluctuations

The study stated that one of the women suddenly lost sight in her left eye the next morning after being injected with Ozempic containing semigroutide. This forced her to stop taking the medication for two months, but resumed taking it because of diabetes. The second week after the re-injection, her right eye was also blind.

Another woman who had been taking semigroutide for a year also woke up one morning to find a painless shadow above her left eye. Tests showed damage to the blood vessels in her retina. Another patient suffered from bleeding in his left eye after taking the drug tezeparatide (Mounjaro).

The report stated that in the study of these cases, it was impossible to determine whether there was a causal relationship between these drugs and the reported ocular complications. However, it is inferred that the rapid blood sugar correction caused by these drugs, rather than the toxic side effects of these drugs, may be related to the reported ocular complications.

Wu Xi, associate professor of the Department of Endocrinology at Huashan Hospital Affiliated to Fudan University, told Lanjing Finance that some foreign papers do contain questions such as the risk of adverse reactions in the eyes, which may be related to increased blood sugar fluctuations after injection of GLP-1 drugs. In addition, it is also related to the fact that most foreign users are heavier, use larger doses, and add drugs faster; There are still many young people who use GLP-1 drugs in China, so there are few reports of eye side effects at present.

Regarding how to avoid eye side effects, Wu Xi pointed out that the dose should be increased slowly, that is, starting from a small dose for one or two months and then entering the next dose gradient. Second, eye examinations should be performed regularly.

Blue Whale Financial asked Novo Nordisk and Lilly about the above incident, but as of press time, the two companies had not responded further.

Can semigroutide become the world ‘s medicine king?

Lilly and Novo Nordisk have always been known in the industry as the duo of weight-loss drugs. Novo Nordisk’s Semiglutide, as the second-generation heavy-weight hypoglycemic and weight-loss product developed by the company, has truly made painless weight loss famous, and has also brought the popularity of GLP-1 drugs to the track.

According to Novo Nordisk’s 2024 financial report recently released, three semigroutide products, namely Rybelsus (Oral hypoglycemic version of semaglutide), Ozempic (hypoglycemic version of semaglutide injection), and Wegovy (weight-loss version of semaglutide injection), the total annual revenue was 201.849 billion Danish kroner (approximately 29.296 billion US dollars), this figure was 145.811 billion Danish kroner (approximately 21.201 billion US dollars) in the same period of 2023, a year-on-year increase of nearly 40%, approaching“” the sales of Merck’s King K drug (pembrolizumab) of US$29.486 billion in 2024, pointing to the global“ king” throne.

It is worth noting that among the three products, Ozempic achieved revenue of 120.342 billion Danish kroner (approximately US$17.462 billion) in the global market, a year-on-year increase of 26%;Rybelsus achieved revenue of 23.301 billion Danish kroner (approximately US$3.381 billion), a year-on-year increase of 24%;Wegovy achieved revenue of 58.206 billion Danish kroner (approximately US$8.446 billion), a year-on-year increase of 86%, with the weight-loss version of Semmeglutide injection growing fastest.

Novo Nordisk’s three semigroutide products have all been launched in China. The annual sales of the hypoglycemic version of semigroutide injection in China reached 5.762 billion Danish kroner (approximately US$836 million), a year-on-year increase of 22%. The weight-loss version of Semigroutide injection was only approved for marketing by the State Food and Drug Administration in June 2024 and was officially commercialized in November 2024, achieving only sales of 196 million Danish kroner (US$28 million). The oral version of semigroutide was approved by the State Food and Drug Administration in January 2024 for the treatment of type 2 diabetes. In 2024, it achieved sales of 511 million Danish kroner (US$74 million). The three together generated approximately US$938 million in revenue.

Morgan Stanley pointed out in a recently released research report that the potential of the global obesity market is still huge, but market expectations are already high and there is still uncertainty about the speed of market formation. Morgan Stanley believes that the market’s widely expected long-term global obesity market size of US$150 billion is credible, provided that obesity drugs have a high penetration rate among obese patients around the world and the price drop is comparable to that of diabetic GLP-1 analogues. The bank added that the main risk to Novo Nordisk’s fiscal year 2025 earnings is Lilly’s gain in the slow-growing U.S. anti-obesity drug (AOM) market.

In fact, Lilly’s large single product, tierpotide, has strong momentum. According to Lilly’s 2024 financial report, sales of the anti-diabetic version of tierpotide Mounjaro alone exceeded US$11.5401 billion, while the anti-diabetic version of tierpotide Mounjaro and the weight-loss version of tierpotide Zepbound The combined revenue reached US$16.4458 billion. With the successive approval and commercialization of multiple indications of tilpositide in the global market, competition in the global medicine king competition has become increasingly fierce.

In addition, internationally, in addition to Novo Nordisk and Lilly, companies such as Boehringer Ingelheim, Amgen, and Roche are all deploying this field. In China, the competition for GLP-1 diet drugs is also entering a white-hot stage.

The patented acylated GLP-1 compound for the core compound of semigroutide will expire on March 20, 2026. In April 2023, Federal Biotechnology (Zhuhai Hengqin), a wholly-owned subsidiary of Federal Pharmaceuticals, applied for semigroutide’s weight management indications were approved for clinical trials, becoming the first company in China to obtain clinical approval for the weight management indications of this biosimilar drug. In addition, companies including Jiuyuan Gene, Lizhu Group, Shijiazhuang Group, Chengdu Beite, Hanyu Pharmaceutical, Huisheng Biotech, Huadong Pharmaceutical, Aimeike, China Resources Shuanghe and other companies have also been approved for clinical trials of semigroutide biosimilars for weight management indications.