From a new multidose Zepbound pen to fresh data on what happens when patients stop taking these drugs, the GLP-1 landscape is shifting fast.
Here’s a roundup of the developments in GLP-1 research, access and policy in the last month:
New form of Zepbound released
Eli Lilly launched a multidose version of Zepbound (tirzepatide) on February 23 after the FDA approved a label expansion to include the four-dose, single-patient-use KwikPen. The device delivers four weekly doses in a single pen, reducing the number of injectors patients need each month.
Study: Stopping GLP-1s doesn’t always mean weight gain
Discontinuing GLP-1 treatment does not always lead to significant weight gain, according to a Cleveland Clinic study published March 12 in Diabetes, Obesity and Metabolism, in part because many patients transition to other treatments. One year after stopping, 19.6% of patients restarted the same GLP-1 and 35.2% received an alternative obesity treatment, including another medication, lifestyle modification or bariatric surgery.
The study followed patients on semaglutide (Ozempic, Wegovy) or tirzepatide (Mounjaro, Zepbound) for Type 2 diabetes or obesity. Among the diabetes group, 44% gained weight a year after stopping, while 56% maintained or lost weight. The obesity cohort fared slightly worse: 55% regained weight, while 45% maintained or continued losing.
Study: Stopping GLP-1s linked to 22% rise in heart events
Discontinuing GLP-1 medications is associated with a 22% increase in heart attack, stroke and death after two years, according to a study published March 18 in BMJ Medicine. Researchers at Washington University School of Medicine in St. Louis followed more than 333,000 U.S. veterans with Type 2 diabetes for three years, about one-third on GLP-1s, the rest on sulfonylureas.
Over the study period, 26% of GLP-1 users stopped treatment and 23% had an interruption of six months or more before resuming. Patients who took GLP-1s consistently for the full three years saw the greatest benefit, with an 18% reduction in heart events. Those who stopped before 18 months saw no significant benefit compared to the sulfonylurea group.
Amazon expands Zepbound access
Amazon Pharmacy has added Zepbound’s 2.5-mg KwikPen starter dose for $299 per month through its cash-pay model. Customers with a valid prescription can order online for home delivery, including same-day delivery in nearly 3,000 cities, a footprint expected to expand to 4,500 locations by the end of 2026. Amazon Pharmacy has offered GLP-1 medications since 2021 and said its platform has saved customers more than $200 million to date, with GLP-1s representing the largest share.
Novo, Hims strike GLP-1 deal after legal feud
Hims & Hers Health has partnered with Novo Nordisk to offer FDA-approved GLP-1 medications, including Ozempic injections and Wegovy in both injectable and tablet form, through its U.S. platform, with availability expected later this month.
The deal follows a swift and public falling-out. In early February, Hims & Hers began selling a compounded version of Novo’s newly approved Wegovy pill for $99 per month. Novo filed a patent infringement lawsuit the same day, and HHS referred the company to the Justice Department over potential federal drug law violations. Hims & Hers pulled the product days later. Under the new agreement, the company will stop advertising compounded GLP-1 offerings and restrict access to them for patients for whom FDA-approved alternatives aren’t clinically appropriate.
Survey: Cost not the primary barrier to GLP-1 use
Despite high list prices and inconsistent insurance coverage, cost is not the main reason Americans are avoiding GLP-1s, according to a March 17 Axios-Ipsos poll. Among those uninterested in the medications, just 16% cited cost. The top reason was a preference for managing weight through diet and exercise (51%), followed by concerns about side effects (38%).
GLP-1 use is nonetheless rising: 18% of Americans said they or someone they know is using a weight loss drug, up from 12% a year ago, and 11% said they’ve personally taken one.
FDA sends Novo Nordisk 2nd warning over GLP-1 ads
Novo Nordisk received a second FDA warning letter in less than a month, this time over a direct-to-consumer TV ad for Ozempic titled “There’s Only One Ozempic.” In a February 26 letter, the FDA said the ad made false or misleading efficacy claims and implied Ozempic is superior to other GLP-1 treatments for Type 2 diabetes without supporting evidence. The agency also flagged that the ad appeared to suggest all adults with Type 2 diabetes qualify for the drug’s approved uses, when certain indications apply only to patients with specific conditions such as cardiovascular disease or chronic kidney disease.
Novo Nordisk inks $2.1B oral obesity drug deal
Novo Nordisk has partnered with Vivtex Corp. to develop oral biologic medicines for obesity, diabetes and related conditions, with Vivtex eligible to receive up to $2.1 billion in upfront and milestone payments plus tiered royalties. The collaboration, announced February 25, aims to overcome a key limitation of peptide and protein therapeutics, poor gastrointestinal absorption, using Vivtex’s drug delivery platform, which combines high-throughput GI screening and AI-driven analytics to improve oral bioavailability.
Study: Should patients halt GLP-1s before endoscopy?
Patients taking GLP-1 or GLP-1/GIP agonists who did not hold their medication before upper endoscopy had significantly higher levels of residual gastric volume — raising aspiration risk during sedation — according to a study published March 16 in JAMA Internal Medicine.
The difference was stark. Patients who continued their medication had a 25% rate of clinically significant RGV, compared to just 3.1% in those who held one dose. In patients undergoing upper endoscopy only, without colonoscopy prep, the disparity was even wider: 46.7% versus 5%. The results were significant enough that the trial was stopped early at the 50% enrollment mark.
One notable finding: patients who also underwent colonoscopy and followed a clear liquid diet the day before had zero cases of clinically significant RGV in either group, suggesting that bowel prep diet may neutralize the risk regardless of medication status.
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