The Korean Society for the Study of Obesity (KSSO) is now busy revising its guidelines ahead of Novo Nordisk's anticipated domestic launch of its obesity treatment Wegovy (semaglutide) late this year.

According to a recent seminar of the Guidelines Committee at the KSSO’s 59th spring conference, the revised guidelines for obesity treatment, finalized by the end of the year, will include a section on Wegovy.

In anticipation of the drug's launch in Korea later this year, the guidelines will include a practical prescribing guide for the drug in the pharmacotherapy section of the guidelines before its use in earnest next year.

However, the tirzepatide-based drug, garnering attention for its weight loss effects alongside Wegovy, "will only be introduced in the revised guideline as its domestic launch is still unclear," the society said.

In June of last year, Eli Lilly Korea received approval from the Ministry of Food and Drug Safety (MFDS) for its tripeptide-based diabetes drug, Mounjaro. Still, the timeline for its domestic launch remains unclear.

This is partly because the global interest in tirzepatide is causing a supply shortage and because Eli Lilly Korea is undergoing an additional approval review to diversify the formulation of Mounjaro in addition to the already approved “prefilled pen” formulation.

Due to delays caused by the Covid-19 pandemic affecting the Good Manufacturing Process (GMP) due diligence schedule of the Ministry of Food and Drug Safety (MFDS), the GMP due diligence for the new formulation of Mounjaro is now unlikely until next year, further diminishing the possibility of a launch within this year.

"With the launch of semaglutide, a GLP-1 receptor agonist, and tirzepatide, a GLP-1/GIP dual agonist, as well as the development of triple agonists currently under development, the weight loss effect has reached double digits," said Professor Jeon Eon-ju of the Department of Endocrinology and Metabolism at Daegu Catholic University School of Medicine, who presented on obesity medications at the seminar.

According to Professor Jeon, semaglutide has been shown to have a weight loss rate of 5 percent in 86 percent of patients and a weight loss rate of 20 percent or more in nearly 30 percent. Tirzepatide showed an even greater weight loss ratio of 5 percent or more in 90 percent of patients and a weight loss rate of 20 percent or more in almost 50 percent.

"These superior weight loss outcomes were similar in Asians, and we are particularly excited to see that these drugs are also effective against visceral obesity, a major cause of obesity in Asia," Professor Jeon said.

The new guidelines will include updates on dose titration for liraglutide (Saxenda in the product name), semaglutide, and tripeptide, the management of their gastrointestinal adverse events, and prescribing cautions for comorbidities and other safety concerns.

"Although the guidelines do not address cost, cost is ultimately the biggest barrier to patient access," Jeon said. Wegovy is expected to cost 1.5 to 2 times the price of Saxenda.