5 ms·
This is subscriber-walled, but the full article is available here: https://web.archive.org/web/20240909093450/https://www.statnews.com/2024/09/09/glp-1-history
by philipkglass 10mo ago
This is subscriber-walled, but the full article is available here:
https://web.archive.org/web/20240909093450/https://www.statnews.com/2024/09/09/glp-1-history-pfizer-john-baxter-jeffrey-flier-calbio-metabio/ https://web.archive.org/web/20240909093450/https://www.statn...
The key reason Pfizer passed was that executives didn't think patients would accept a new therapy that required injection to administer:
Despite our emerging results, the Pfizer executives in charge of research and external alliances told us the company did not want to develop a new diabetes therapy that required injection, a space held exclusively by insulin since 1922. They gave us a year to find a way to deliver GLP-1 via transnasal, transcutaneous, or oral administration. Effective delivery by any of these approaches would have been great, but we knew success was unlikely in the year they gave us. Our effort was predictably unsuccessful, and after four years, Pfizer terminated our agreement as permitted under the alliance contract.
The first commercial GLP-1 receptor agonist, Exenatide, went to market as an injectable medication in 2005 [1]. Orally delivered GLP-1 medications didn't come to market until 2019 when orally dosed semaglutide was approved as Rybelsus [2].
Now that injected GLP-1 drugs are among the most-prescribed drugs in America, I wonder if drug company executives are going to be more receptive to drug candidates that require injections. There are a lot of molecules (especially peptides) that are degraded by the digestive system; maybe people will be more willing to inject medications when so many have started self-injecting for GLP-1 drugs or know someone who has.
[1] https://en.wikipedia.org/wiki/Exenatide https://en.wikipedia.org/wiki/Exenatide
[2] https://en.wikipedia.org/wiki/Semaglutide#Legal_status https://en.wikipedia.org/wiki/Semaglutide#Legal_status
- Scaevolus 10mo agoSelf-injecting feels like a scary, painful, dangerous procedure and becomes completely boring by the third repetition.
- s5300 10mo ago[dead]
- stavros 10mo agoIt really helps that the needles are hair-thin and short.
- firesteelrain 10mo agoThe proprietary injector mechanism like for Mounjaro makes it really easy for users. Even compounded versions of it use tiny insulin needles that have near zero pain when injected into the subcutaneous portion of like the stomach while pinched. Source: I took compounded Mounjaro and compounded Ozempic/semaglutide.
- OptionOfT 10mo agoDo you still take it? I'm looking for some more information on compounded GLP-1 and their safety.
- firesteelrain 10mo agoI stopped taking compound Mounjaro a year ago. I started semaglutide in Sept and stopped because it made me sick (throwing up, other non desirable GI effects). My body couldn’t handle semaglutide.
- sincerely 10mo agoReportedly retatruide doesn’t cause nausea in as many people, but can still cause diarrhea. May still be worth looking into if you’re interested
- kotaKat 10mo agoSimilarly, I grabbed one of the over-the-counter CGM biosensors (Stelo) to gather some data for a couple of weeks and the initial fear of "holy hell, I'm slamming a needle into my arm with something stuck to it" goes away as soon as you slap the injector release. Just one little clap sound, you feel a little pat on your arm, and the sensor's already made it where it needed to with no pain. When you remove the sensor it's a little bit of a shock when you see the sensor wire and realize just how small it was and how you never felt it run around inside your arm for a couple weeks.
- butvacuum 10mo agofyi: the impact is an intentional decision. if your nerve endings are signaling something else(hot, cold, movement, etc), a needle prick can get blurred with the rest or ignored altogether. I suspect the bang/clag CGM applicators produce are much the same. and, for me, its always been the needle moving around thats been mentally disturbing. digging around vecause they missed for the blood draw, trying to hold a large vaccination dose steady as it needs to be injected over 20seconds. So, I suspect the speed itself reduces discomfort.
- cm2187 10mo agoI concur, exactly the way I felt before and after.
- amelius 10mo agoIsn't there some long term harm to the skin if you do this often?
- thaumasiotes 10mo agoTo the skin? Probably not. Heroin addicts and presumably anyone else who frequently injects into a vein can cause damage to the veins.
- nkrisc 10mo agoSeems completely negligible to the normal amount of tiny cuts and scrapes you accumulate on any given day.
- dgares 10mo agoYes, but only if you do it in the same spot every time.
- sowbug 10mo agoInsulin users would have better answers to this question, since they might inject multiple times a day, whereas GLP-1 users typically inject only weekly. But in either case, the answer for subcutaneous injections using needles sized 29g and smaller is no.
- cperciva 10mo agoInjection drug user here. We're advised to rotate injection sites but the largest issue is actually the insulin (most of it diffuses into the bloodstream but there is a local effect, usually taking the form of increased fat accumulation at sites of repeated injection), not the "making holes in the skin" part. I don't know the pharmacokinetics of GLP-1 drugs but my guess is that they don't have the same sort of effects on SC tissue? Before I had a CGM I did somewhere around 20,000 blood glucose tests over the course of a decade using about 1 cm^2 of forearm and the skin there is clearly not in great shape -- but it's worsened on the level of "looks like the skin of someone who is a decade older or spent too long in the sun" rather than anything medically problematic.
- Projectiboga 10mo agoType 1 insulin user. One the alcohol should dry before the needle goes in. Two faster is better, within reason. Three about one in a few hundred shots hits a nerve bundle. That really hurts, but resolves after a short while. Both insulin and these GLP-1 injections are subcutaneous not intravenous which once a patient gets the skill it becomes like riding a bike, in that it becomes easier than imagined.
- nextos 10mo agoFWIW, Novo Nordisk also tried to kill their GLP-1 effort several times according to the project lead, Lotte Bjerre Knudsen: https://archive.is/oLnBl https://archive.is/oLnBl In large organizations, I guess a big chunk of success comes from being able to navigate all these political ups and downs.
- RobotToaster 10mo agoI wonder how many other great medical innovations have disappeared because of such bureaucracy.
- DANmode 10mo agoHow long do you have? https://www.sciencenews.org/article/vaccine-beer-polyomavirus-chris-buck https://www.sciencenews.org/article/vaccine-beer-polyomaviru...
- estearum 10mo agoBureaucracy? This is the same type of go/no-go decision that R&D orgs have to make with incomplete information and immense costs every day. But with less complete information (no in-human data → 70-90% failure rate) and more immense costs (a couple hundred million dollars to get it through trials). The problem is the cost and risk profile of drug development. With those parameters where they are, there will be countless "bureaucratic errors" of foregone opportunities, most of which we'll never even learn about.
- lotsofpulp 10mo agoTechnically, they disappeared because of limited resources. If every pharmaceutical organization had unlimited funding to run unlimited trials, then they would.
- petesergeant 10mo agoIt's worth bearing in mind that the reality of self-injector pens with tiny needles today is not the reality of syringes 30 years ago.
- randycupertino 10mo agoPfizer has been resting on their laurels ever since it struck gold with boner pills and Lipitor. Viagra made it rain beaucoup bucks and rewired the entire firm to prioritize commercial sales and marketing over real scientific clinical development. Pfizer is optimized for sales over research and development. Now they primarily acquire and license a bunch of me-too drugs and late-stage acquisitions vs creating their own homegrown breakthroughs. Pfizer's strengths are regulatory compliance, M&A and global manufacturing. They suck at research and clinical development. Losing the GLP-1 race was predictable as they simply don't prioritize emerging science compared to other mid-sized and large pharmas.