{"id":610650,"date":"2024-02-28T22:42:58","date_gmt":"2024-02-28T19:42:58","guid":{"rendered":"https:\/\/en.buradabiliyorum.com\/the-canadian-doctor-who-helped-invent-ozempic\/"},"modified":"2024-02-28T22:42:58","modified_gmt":"2024-02-28T19:42:58","slug":"the-canadian-doctor-who-helped-invent-ozempic","status":"publish","type":"post","link":"https:\/\/buradabiliyorum.com\/en\/the-canadian-doctor-who-helped-invent-ozempic\/","title":{"rendered":"#The Canadian doctor who helped invent Ozempic"},"content":{"rendered":"
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(Photography by Wade Hudson)<\/p>\n<\/div>\n

When it comes to diabetes drugs, there\u2019s just something about Toronto researchers. In 1984, 63 years after Banting and Best isolated insulin, Daniel Drucker, another U of T alumnus, co-discovered glucagon-like peptide-1, or GLP-1, a gut hormone that lowers blood sugar and suppresses app<\/a>etite. Drucker and Co.\u2019s eureka moment was exciting-ish in endocrinology circles. But it wasn\u2019t until decades later, when a GLP-1-mimicking drug called semaglutide proved effective for weight loss, that their work became the shot taken \u2019round the world.<\/span><\/p>\n

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\u00a0The ripples of the \u201cOzempic effect\u201d are now unfathomably huge: a suite of ever-more GLP-1 drugs (Wegovy, Mounjaro and Rybelsus), a soon-to-be $100-billion industry, <\/span>so many<\/span><\/i> op-eds about our screwed-up body politics, witch hunts around celebrity users and, on a more serious note, widespread shortages that are expected to last through 2024. For Drucker, now a senior scientist at Toronto\u2019s Lunenfeld-Tanenbaum Research Institute and a Canadian Medical Hall of Famer, Ozempic (and other GLP-1 drugs) is no vanity project. He\u2019s already back in the lab.<\/span><\/p>\n

You recently shot to fame as one of the pioneers of Ozempic, but you\u2019ve been an endocrinologist for the last 40 years. What about diabetes initially piqued your interest? Or was it plain old scientific curiosity?\u00a0\u00a0<\/b><\/p>\n

My first love was actually thyroid disease, thanks largely to my mentor, a specialist who came to U of T from Yale. In 1984, I went to Boston to work on a thyroid project at Massachusetts General<\/a> Hospital. When I got there, they said, \u201cThat\u2019s full now. You\u2019ll have to work on this new glucagon thing.\u201d I think I went home and said to my wife, \u201cThis seems like a loser project, but I\u2019m just gonna make the best of it.\u201d And, well, we know what happened.\u00a0<\/span><\/p>\n

You and some of your international colleagues discovered the diabetes-fighting potential of insulin\u2019s cousin, GLP-1, which eventually led to the creation of Ozempic. Did you have any inkling back then of the magnitude of what you\u2019d stumbled on?\u00a0\u00a0\u00a0<\/b><\/p>\n

I was excited by the results, but I was equally excited by the fact that my <\/span>boss<\/span><\/i> was excited about them. I was a 28-year-old trainee making $20,000-something a year. I had a child\u2014and a lot more black hair than I do now\u2014but not a lot of job security. I thought, <\/span>This is cool<\/span><\/i>, but another part of my brain was thinking, <\/span>Maybe I can publish some papers. Maybe I\u2019ll\u00a0 get a job.<\/span><\/i>\u00a0<\/span><\/p>\n

Later on, your research involved a venomous lizard\u2014a Gila monster, to be precise. Whose idea was that?\u00a0\u00a0<\/b><\/p>\n

The person who deserves credit for that is John Eng, an endocrinologist from the Bronx. He sequenced proteins from the lizard\u2019s venom and found two that looked like human GLP-1: exendin-3 and 4. I read his papers in 1992 and said, \u201cThat\u2019s really weird! Does the lizard have GLP-1, too?\u201d To answer that, I had to clone its genes.\u00a0<\/span><\/p>\n

How did you do <\/b>that<\/i><\/b>?\u00a0<\/b><\/p>\n

First, I tried to get some DNA from dead lizard chunks stored at the Royal Ontario Museum. The ROM\u2019s lizard specialist, Bob Murphy\u2014who\u2019s still there\u2014had some in the freezer. When that didn\u2019t work, we had to get a live Gila, which aren\u2019t sold in the pet stores at the mall. The most reputable person who could get me one was a guy who ran the Utah Zoo. He just said, \u201c250 bucks.\u201d Murphy arranged all the permits.\u00a0<\/span>
\n\"\"Can you gauge for me the level of excitement around GLP-1 way back when?\u00a0<\/b><\/p>\n

When I gave talks about it at the Endocrine Society in the \u201990s, there was usually one person in the room. There were already pills you could take to stimulate insulin secretion, so people were like, \u201cWhy would you inject something that comes from a poisonous lizard?\u201d It took a long time for enthusiasm to build.<\/span><\/p>\n

Flash forward 30 years and things couldn\u2019t be more different: Ozempic is advertised everywhere. Rybelsus has its own billboard up the street from my house. Do you ever feel bitter about the fact that it took these meds becoming weight-loss remedies for people to get excited about your work?<\/b><\/p>\n

No. In science<\/a>, you have a one in 10,000 chance of your research going from lab to drug. I\u2019ve been involved with the GLP-1 discovery, and also drugs like Januvia (for Type 2 diabetes) and Gattex (for short bowel syndrome). It\u2019s an unbelievable privilege to be associated with science that treats human disease, and I\u2019ve won the lottery over and over again. Bitter is the last word that would cross my mind.<\/span><\/p>\n

Pharma companies have always been in the business of \u201cmiracle drugs,\u201d but GLP-1 might be the one class of meds in recent memory that seems to warrant its hype. Yes, they\u2019re normalizing people\u2019s blood sugar levels, but they also quiet the constant mental hum of food cravings. Patients who have struggled with obesity their entire lives are finally losing weight. For the skeptics out there: are these drugs too good to be true?<\/b><\/p>\n

So, there\u2019s no free lunch, so to speak. Gastrointestinal complaints are the most common side effects, but half of people don\u2019t have them. The reports we\u2019re seeing of bowel obstructions are rare. These drugs aren\u2019t a panacea, but the risk-benefit ratio is generally very positive. What <\/span>does <\/span><\/i>worry me is people shipping themselves some 1-800 mail-order, black-market drugs without first talking to a doctor.<\/span><\/p>\n

Some experts have said that we may also look back on GLP-1 drugs as one of the greatest modern advancements in the treatment of chronic conditions. They\u2019ve already shown promise for cardiovascular, liver and kidney disease, and some are now being tested on Alzheimer\u2019s, sleep apnea, PCOS\u2014even addictive behaviours, like gambling. That is a <\/b>huge<\/i><\/b> scope.\u00a0\u00a0<\/b><\/p>\n

Are these drugs going to help all of these different conditions in a meaningful way? That\u2019s unlikely. We don\u2019t yet have enough data to say we should put this stuff in the drinking water, but there are encouraging signs of their benefits. Right now, we have excellent data for Type 2 diabetes, heart disease and obesity. We\u2019re gonna get some excellent data for kidney disease in the next few months, then heart failure in the summer. We\u2019ll have to wait a year or two for Parkinson\u2019s and Alzheimer\u2019s.\u00a0<\/span><\/p>\n

A future with less chronic disease? There\u2019s a rare bit of good news<\/a> for the Canadian health-care system!\u00a0<\/b><\/p>\n

Maybe. Again, we can\u2019t assume anything until we have the data. Health-care economists already study this sort of thing, though: how much do the drugs cost? How many people will we have to treat to see a major expense reduction? Let\u2019s wait to see stats. Sorry, I\u2019m so boring.<\/span><\/p>\n

Food-industry experts seem to think Ozempic is starting to change our shopping habits. The CEO of Novo Nordisk, the Danish manufacturer of Ozempic and Wegovy, has apparently already been fielding worried calls from junk-food suppliers.<\/b><\/p>\n

Less than one per cent of people with obesity are taking these drugs, so I think a lot of that is hype, too. When some businesses miss their targets, they go, \u201cIt was the Ozempic effect!\u201d It\u2019s a convenient excuse. Walmart just claimed that shoppers who use Ozempic and Wegovy are buying less food.<\/span>
\n\"\"Ozempic\u2019s certainly provided an interesting Rorschach test for our cultural neuroses around weight. There\u2019s hope that the rise of GLP-1 drugs might help pry us away from the mindset that obesity is a moral failing, rather than a complex biological process. Have you had those chats with your peers?<\/b><\/p>\n

Yes, and that \u201cmoral failing\u201d bias extends to health-care professionals, too. For decades, I\u2019ve had patients do everything I ask them to\u2014limit non-healthy foods, exercise to the maximum extent they can\u2014and they <\/span>still<\/span><\/i> struggle to lose weight. Drugs like Ozempic have allowed them to say, \u201cSee? I needed help, just as I would with Crohn\u2019s disease or MS or any one of 150 other diseases a person can\u2019t just will away.\u201d\u00a0<\/span><\/p>\n

Witnessing those before-and-afters must be pretty powerful.\u00a0<\/b><\/p>\n

It\u2019s hard for me to go out and <\/span>not<\/span><\/i> meet someone who\u2019s taken these drugs. Recently, a close family member came up to me at a party and said, \u201cIt used to take me an hour to go food shopping, because I\u2019d have to read every label and see how many calories and what percentage of fat was in each product. I had to scrutinize everything I put in my cart. Now, it takes me 15 minutes. I\u2019m not going to overeat and I\u2019m healthier.\u201d Wow, you know?<\/span><\/p>\n

There\u2019s also the flip side, though: \u201cTaking Ozempic? You\u2019ve taken the easy way out. Don\u2019t bother calling yourself body positive.\u201d What do you make of that backlash?<\/b><\/p>\n

Someone recently sent me an article about body-positive influencers\u2014some with a lot of followers\u2014who are going from espousing the view that we should be comfortable with our size to accepting money from drug companies to say, \u201cHey, what about Ozempic?\u201d I understand the backlash to that. I also know that, on social media<\/a>, people take pleasure in taking shots at other people without having lived in their bodies.\u00a0<\/span><\/p>\n

You\u2019ve provided guidance to Novo Nordisk on GLP-1 drug development. What recommendations did you give them?<\/b><\/p>\n

One is to avoid supply-chain issues. These companies have admitted they didn\u2019t anticipate the phenomenal demand for their blockbuster drugs. It\u2019s going to take time\u2014and billions of dollars\u2014to build more plants, which they\u2019re doing now.<\/span><\/p>\n

To help stem the Ozempic shortages, the Ontario government recently changed its listing under the provincial drug benefit program. Now, people who use Ozempic off-label\u2014for weight loss rather than diabetes\u2014will have to pay out-of-pocket. In Canada, that amounts to roughly $300 a month. Do you think that was a wise move?\u00a0<\/b><\/p>\n

When you have a shortage, you have to prioritize the people at the greatest risk. But pharmacists don\u2019t ask patients, \u201cDo you <\/span>really<\/span><\/i> need this drug?\u201d It\u2019s a challenging discussion, but decisions have to be made. Whether or not this is just a convenient way for the government to limit supply, you\u2019d have to ask them.<\/span><\/p>\n

What else have you told Novo Nordisk?\u00a0<\/b><\/p>\n

There\u2019s no point in having an amazing, helpful drug if people can\u2019t afford it. We\u2019ve had such ethical conversations before\u2014with HIV, hepatitis, COVID vaccines. The story of insulin hasn\u2019t been a great look for the States. Until very recently, it was still prohibitively expensive\u2014and people were still dying\u2014100 years after its discovery. That shouldn\u2019t happen in wealthy societies.<\/span><\/p>\n

Your name is also listed in Novo Nordisk\u2019s literature about the discovery of Ozempic. I know you\u2019re not in the research biz for the money, but do you receive royalties?<\/b><\/p>\n

The GLP-1 drugs brought in some revenue to Mass General\u2014and my boss\u2014but not me. I\u2019ve never received a loonie.<\/span><\/p>\n

Damn.<\/b><\/p>\n

I don\u2019t know what I\u2019d do with that money, to be honest\u2014maybe my grandchildren would never work? I have a good life, but I don\u2019t drive fancy cars or wear expensive clothes. My wife\u2019s always saying, \u201cWhy don\u2019t you buy a new suit?\u201d I have six suits!\u00a0<\/span><\/p>\n

Have you seen<\/b> Oppenheimer<\/i><\/b>?<\/b><\/p>\n

I have.<\/span><\/p>\n

Do you have any Pandora\u2019s box\u2013style worries about Ozempic and its ilk? Any regrets about what you\u2019ve helped unleash?\u00a0<\/b><\/p>\n

Ten years ago, I would\u2019ve been more anxious. Around 2011, there were concerns that GLP-1 drugs could cause pancreatitis and cancer. Public Citizen, an entity that scrutinizes drug safety, petitioned the FDA to remove them from the market. We didn\u2019t have the data we have now\u2014or the benefit of seeing millions of people successfully treated over the course of 19 years. So I don\u2019t lie awake at night, but I respect what I don\u2019t know. I\u2019ll never say these drugs are <\/span>completely<\/span><\/i> safe, or that we\u2019ll never learn anything more about them. That\u2019s just not me\u2014and that\u2019s not how medicine works.\u00a0<\/span><\/p>\n

It occurs to me that someone who\u2019s chosen to work in a lab for a living might not be suited to the level of attention that Ozempic has generated. Has that spotlight changed the way you work?<\/b><\/p>\n

I\u2019m turning down a lot more invitations to speak due to time constraints. That\u2019s a nice problem to have. Our lab feels really good about the work, but it doesn\u2019t change the science we do. I\u2019d rather look at a cool picture my granddaughter drew than review the latest sales of Mounjaro.\u00a0<\/span><\/p>\n

Is there such a thing as a sophomore slump for scientists? How do you follow Ozempic?<\/b><\/p>\n

In January, our team published a brand-new finding in <\/span>Cell Metabolism<\/span><\/i> that showed that GLP-1 reduces inflammation in the body\u2019s peripheral tissues, like the lung and white blood cells, through the brain. A lot of what GLP-1 does is magic, and we\u2019re still trying to figure out how the magic happens. We\u2019re 40 years into this story, but we could just be at the beginning.\u00a0<\/span><\/p>\n<\/div>\n