Key Takeaways
- Health Canada has approved a GLP-1 pill, Rybelsus, for reducing the risk of heart disease and Type 2 diabetes in adults.
- The pill is the first of its kind to be approved in Canada, with all other GLP-1 drugs available in the country being injectables.
- Rybelsus has been shown to lower the risk of cardiovascular events, such as heart attacks, and can be used in conjunction with diet and exercise to improve blood sugar levels.
- Recent research suggests that the effects of GLP-1 medication, including Rybelsus, may be short-lived, with patients regaining weight and losing cardiovascular benefits after stopping treatment.
Introduction to Rybelsus
Health Canada has approved a new pill, Rybelsus, for the treatment of Type 2 diabetes and reduction of heart disease risk. The pill, manufactured by Novo Nordisk, is a glucagon-like peptide-1 (GLP-1) drug, the same type of medication as injectables Ozempic and Wegovy. Rybelsus is the first GLP-1 pill to be approved in Canada, with all other GLP-1 drugs available in the country being injectables. The pill has been approved for adults with Type 2 diabetes who also have a cardiovascular disease or are at high risk for heart disease.
Clinical Trials and Effectiveness
The approval of Rybelsus is based on a trial of 9,650 patients who were randomized to receive either Rybelsus 14 mg or a placebo daily. The trial showed that the use of Rybelsus lowered the risk of cardiovascular events, such as heart attacks, and can be used in conjunction with diet and exercise to improve blood sugar levels. The Rybelsus website states that the pill can work "along with diet and exercise to improve blood sugar (glucose) in adults with type 2 diabetes" and can also be used to "reduce the risk of major cardiovascular events such as heart attack, stroke or death in adults with type 2 diabetes mellitus who are at high risk for these events."
Short-Lived Effects of GLP-1 Medication
Recent research suggests that the effects of GLP-1 medication, including Rybelsus, may be short-lived. A review of 63 trials covering more than 9,000 individuals published in the British Medical Journal found that weight-loss drug users, on average, regain weight at a rate of 0.4 kilograms per month after they stop taking their weight-loss medications. Furthermore, when patients regain the weight they lost, the cardiovascular benefits of the GLP-1 drug also go away. This is a concern for patients who may be considering Rybelsus or other GLP-1 medications for weight loss or cardiovascular risk reduction.
Comparison to Injectable Versions
The oral semaglutide pill, Rybelsus, may not be as effective as the injectable versions of GLP-1 medications, such as Ozempic and Wegovy. Dr. Fahad Razak, an internal medicine physician at St. Michael’s Hospital and professor at the University of Toronto, notes that the weekly injection is a more effective means of weight loss, but the oral alternative may be more palatable to some patients. Jennifer Lake, pharmacist and assistant professor at Leslie Dan Faculty of Pharmacy at the University of Toronto, explains that the oral pill may come in larger doses than the injectable versions in order to make them similarly effective, as the stomach disintegrates some of the protein when taken orally.
Availability and Cost
Rybelsus is currently available in the United States, where it was approved by the FDA last month, and is expected to be available in Canada soon. The cost of the pill in the US is around $149 per month, or $5 per day. However, the company warns users to check with their doctor about possible side effects before considering the medication. As with any new medication, it is essential for patients to discuss the potential benefits and risks of Rybelsus with their healthcare provider to determine if it is the right treatment option for them.
