The weight-loss drug Wegovy, made by the manufacturers of Ozempic, will be available to patients in Canada starting Monday, the company says.
Novo Nordisk’s weekly injection is approved for weight loss among patients diagnosed with obesity.
Wegovy can also be prescribed to patients who are significantly overweight and have at least one related medical condition such as high blood pressure, Type 2 diabetes or obstructive sleep apnea.
Health Canada approved Wegovy in November 2021, but it’s taken about two and a half years to bring it to market amid supply shortages of Ozempic, which is only approved to treat Type 2 diabetes but has been prescribed off-label for weight loss.
The two drugs have the same active ingredient but Wegovy carries a higher weekly dose of semaglutide at 2.4 milligrams, compared to 1 mg in a single Ozempic dose.
Dr. Ehud Ur, an endocrinologist in Vancouver, said Wegovy allows Novo Nordisk “to segment out the two markets for obesity and diabetes.”
“But, you know, they’re intimately related,” said Ur, who is not affiliated with Novo Nordisk.
“I mean, much of diabetes is caused by obesity. Many people with obesity are prone to developing diabetes. So it’s a complex interaction.”
Health Canada approved Wegovy based on studies that “demonstrated a statistically significantly greater amount of weight loss in semaglutide-treated (patients) as compared to placebo-treated subjects,” according to the federal government’s website.
Semaglutide mimics a hormone called glucagon-like peptide-1 (GLP-1) which promotes insulin production. It also suppresses appetite in the brain and works in the stomach so people feel fuller when they eat.
The insulin effect to treat diabetes can be achieved with a lower dose of semaglutide, but a higher dose increases the appetite suppressant effect, which is why Wegovy is a higher dose than Ozempic, Ur said.
Clinical trials showed that Wegovy was not only safe and effective for weight loss, but also had a positive impact on other weight-related conditions such as cardiovascular health, he said.
Dr. Sanjeev Sockalingam, scientific director for Obesity Canada, said obesity is a medical condition and Wegovy will be an important treatment option.
“(Wegovy) adds to the tool box and the tool kit for all clinicians who are seeing many patients living with obesity,” said Sockalingam, whose organization estimates at least eight million Canadian adults have obesity.
Obesity Canada will update its medication guidelines to include Wegovy, which is meant to be used in tandem with physical activity and nutrition, he said.
Obesity is defined as a body mass index (BMI) of 30 kilograms per square metre or greater, according to Health Canada.
In addition to patients with obesity, doctors can prescribe Wegovy to patients with a BMI of 27 kilograms per square metre and at least one weight-related medical condition. That could include hypertension, Type 2 diabetes, dyslipidemia (an imbalance of lipids such as cholesterol or triglycerides) and obstructive sleep apnea.
Wegovy arrives after extensive marketing of Ozempic and a social media-driven surge in demand for its off-label use for weight loss. Experts say it’s critical that prescribers, including family doctors, ensure Wegovy is only given to patients who meet specific criteria.
“Physicians are ultimately the gatekeepers of this, and hopefully there will be responsible prescribing for the medication,” said Ur.
Sockalingam stressed that when it comes to prescribing Wegovy, “we want to make sure we’re very precise, that we’re not talking about … cosmetic or physical appearance.”
“This is a medical treatment for a medical condition.”
The founder of a support group for people living with obesity called the arrival of Wegovy in Canada “a milestone moment.”
“(It is) signaling a growing recognition of obesity as a serious health issue that requires comprehensive treatment solutions,” said Priti Chawla, executive director of Obesity Matters.
But the high cost of Wegovy raises the issue of equitable access, Chawla said.
“Many in our community, and especially those in the lower socioeconomic bracket, they find these treatments are financially out of reach,” she said.
“It’s essential that we work towards making Wegovy affordable and accessible to all Canadians who need it.”
Novo Nordisk Canada would not provide a specific price for Wegovy to The Canadian Press, saying in a statement that “medication pricing in Canada is influenced by multiple factors including federal, provincial and territorial governments and insurance providers, and prices may vary person to person.”
But multiple experts estimated it would likely cost around $400 a month.
Now that there is a drug specifically approved for weight loss, insurance companies “have to state specifically whether they will or will not cover this product,” said Dr. Sean Wharton, an internal medicine specialist who treats patients with Type 2 diabetes and obesity in the Toronto area.
Wharton conducts research with several drug companies developing diabetes and weight loss medications, including Novo Nordisk.
The most common side effects found in Wegovy clinical trials were gastrointestinal, including nausea, vomiting diarrhea, constipation and abdominal pain, said both Ur and Wharton.
Starting with a low dose and gradually increasing it to the 2.4 mg maintenance dose should help alleviate those symptoms, they said.
Some participants in the study also reported headache, fatigue and dizziness, Novo Nordisk’s Wegovy web page said.
Semaglutide has been associated with thyroid tumours in rodents, the web page said.
There has never been a case of thyroid tumours in humans taking Ozempic or Wegovy and there is no evidence to suggest any risk to humans, Wharton said.
Ur agreed, saying someone would only be at risk if they were among the “handful” of people in Canada who already have the rare thyroid tumour.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
MILWAUKEE (AP) — Whooping cough is at its highest level in a decade for this time of year, U.S. health officials reported Thursday.
There have been 18,506 cases of whooping cough reported so far, the Centers for Disease Control and Prevention said. That’s the most at this point in the year since 2014, when cases topped 21,800.
The increase is not unexpected — whooping cough peaks every three to five years, health experts said. And the numbers indicate a return to levels before the coronavirus pandemic, when whooping cough and other contagious illnesses plummeted.
Still, the tally has some state health officials concerned, including those in Wisconsin, where there have been about 1,000 cases so far this year, compared to a total of 51 last year.
Nationwide, CDC has reported that kindergarten vaccination rates dipped last year and vaccine exemptions are at an all-time high. Thursday, it released state figures, showing that about 86% of kindergartners in Wisconsin got the whooping cough vaccine, compared to more than 92% nationally.
Whooping cough, also called pertussis, usually starts out like a cold, with a runny nose and other common symptoms, before turning into a prolonged cough. It is treated with antibiotics. Whooping cough used to be very common until a vaccine was introduced in the 1950s, which is now part of routine childhood vaccinations. It is in a shot along with tetanus and diphtheria vaccines. The combo shot is recommended for adults every 10 years.
“They used to call it the 100-day cough because it literally lasts for 100 days,” said Joyce Knestrick, a family nurse practitioner in Wheeling, West Virginia.
Whooping cough is usually seen mostly in infants and young children, who can develop serious complications. That’s why the vaccine is recommended during pregnancy, to pass along protection to the newborn, and for those who spend a lot of time with infants.
But public health workers say outbreaks this year are hitting older kids and teens. In Pennsylvania, most outbreaks have been in middle school, high school and college settings, an official said. Nearly all the cases in Douglas County, Nebraska, are schoolkids and teens, said Justin Frederick, deputy director of the health department.
That includes his own teenage daughter.
“It’s a horrible disease. She still wakes up — after being treated with her antibiotics — in a panic because she’s coughing so much she can’t breathe,” he said.
It’s important to get tested and treated with antibiotics early, said Dr. Kris Bryant, who specializes in pediatric infectious diseases at Norton Children’s in Louisville, Kentucky. People exposed to the bacteria can also take antibiotics to stop the spread.
“Pertussis is worth preventing,” Bryant said. “The good news is that we have safe and effective vaccines.”
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AP data journalist Kasturi Pananjady contributed to this report.
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The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
How a sperm and egg fuse together has long been a mystery.
New research by scientists in Austria provides tantalizing clues, showing fertilization works like a lock and key across the animal kingdom, from fish to people.
“We discovered this mechanism that’s really fundamental across all vertebrates as far as we can tell,” said co-author Andrea Pauli at the Research Institute of Molecular Pathology in Vienna.
The team found that three proteins on the sperm join to form a sort of key that unlocks the egg, allowing the sperm to attach. Their findings, drawn from studies in zebrafish, mice, and human cells, show how this process has persisted over millions of years of evolution. Results were published Thursday in the journal Cell.
Scientists had previously known about two proteins, one on the surface of the sperm and another on the egg’s membrane. Working with international collaborators, Pauli’s lab used Google DeepMind’s artificial intelligence tool AlphaFold — whose developers were awarded a Nobel Prize earlier this month — to help them identify a new protein that allows the first molecular connection between sperm and egg. They also demonstrated how it functions in living things.
It wasn’t previously known how the proteins “worked together as a team in order to allow sperm and egg to recognize each other,” Pauli said.
Scientists still don’t know how the sperm actually gets inside the egg after it attaches and hope to delve into that next.
Eventually, Pauli said, such work could help other scientists understand infertility better or develop new birth control methods.
The work provides targets for the development of male contraceptives in particular, said David Greenstein, a genetics and cell biology expert at the University of Minnesota who was not involved in the study.
The latest study “also underscores the importance of this year’s Nobel Prize in chemistry,” he said in an email.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
Patients who are older, don’t speak English, and don’t have a high school education are more likely to experience harm during a hospital stay in Canada, according to new research.
The Canadian Institute for Health Information measured preventableharmful events from 2023 to 2024, such as bed sores and medication errors,experienced by patients who received acute care in hospital.
The research published Thursday shows patients who don’t speak English or French are 30 per cent more likely to experience harm. Patients without a high school education are 20 per cent more likely to endure harm compared to those with higher education levels.
The report also found that patients 85 and older are five times more likely to experience harm during a hospital stay compared to those under 20.
“The goal of this report is to get folks thinking about equity as being a key dimension of the patient safety effort within a hospital,” says Dana Riley, an author of the report and a program lead on CIHI’s population health team.
When a health-care provider and a patient don’t speak the same language, that can result in the administration of a wrong test or procedure, research shows. Similarly, Riley says a lower level of education is associated with a lower level of health literacy, which can result in increased vulnerability to communication errors.
“It’s fairly costly to the patient and it’s costly to the system,” says Riley, noting the average hospital stay for a patient who experiences harm is four times more expensive than the cost of a hospital stay without a harmful event – $42,558 compared to $9,072.
“I think there are a variety of different reasons why we might start to think about patient safety, think about equity, as key interconnected dimensions of health-care quality,” says Riley.
The analysis doesn’t include data on racialized patients because Riley says pan-Canadian data was not available for their research. Data from Quebec and some mental health patients was also excluded due to differences in data collection.
Efforts to reduce patient injuries at one Ontario hospital network appears to have resulted in less harm. Patient falls at Mackenzie Health causing injury are down 40 per cent, pressure injuries have decreased 51 per cent, and central line-associated bloodstream infections, such as IV therapy, have been reduced 34 per cent.
The hospital created a “zero harm” plan in 2019 to reduce errors after a hospital survey revealed low safety scores. They integrated principles used in aviation and nuclear industries, which prioritize safety in complex high-risk environments.
“The premise is first driven by a cultural shift where people feel comfortable actually calling out these events,” says Mackenzie Health President and Chief Executive Officer Altaf Stationwala.
They introduced harm reduction training and daily meetings to discuss risks in the hospital. Mackenzie partnered with virtual interpreters that speak 240 languages and understand medical jargon. Geriatric care nurses serve the nearly 70 per cent of patients over the age of 75, and staff are encouraged to communicate as frequently as possible, and in plain language, says Stationwala.
“What we do in health care is we take control away from patients and families, and what we know is we need to empower patients and families and that ultimately results in better health care.”
This report by The Canadian Press was first published Oct. 17, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
