Dr. Harith Rajagopalan sees the rise of weight-loss drugs like Wegovy and Ozempic as a massive opportunity—and a troubling trend. Millions are using GLP-1 agonists to tackle obesity and diabetes. However, studies reveal that most patients stop these injections within two years, losing long-term benefits and wasting billions in healthcare costs.
Dr. Rajagopalan, a cardiologist and co-founder of Fractyl Health, advocates for a deeper solution. His company is working on Rejuva, a gene therapy aimed at getting the body to produce its own GLP-1 hormone for years after just one treatment. “We’re literally burning tens of billions of dollars,” he stated regarding the current model relying on ongoing injections.
Fractyl’s method involves using a benign virus to deliver genetic instructions directly to the pancreas, encouraging it to release GLP-1 hormone. This localized production may reduce side effects like nausea, which many patients experience with traditional drugs.
However, there are concerns. Gene therapy’s permanence is a double-edged sword. “If someone experiences negative effects, what can you do?” asks Giles Yeo, a geneticist from the University of Cambridge. Unlike pills or injections, gene therapy isn’t easy to reverse.
Some experts are particularly cautious about the potential for long-term effects of high GLP-1 levels in the pancreas, which is not meant to be the primary production site for this hormone. While initial animal studies suggest a “self-limiting mechanism,” questions about safety linger.
In a crowded market, Fractyl faces stiff competition from major players like Novo Nordisk and Eli Lilly, which are developing their next-generation weight-loss drugs. Despite their innovation, Fractyl faces financial hurdles. Recent regulatory filings reveal their operations could only be funded through 2026, putting pressure on upcoming diabetes trials.
On the financial front, shares in other companies exploring similar therapies, like Wave Life Sciences, surged after promising results, highlighting market trends favoring “gene-lite” solutions.
Patients’ challenges add another layer to the narrative. Dr. Fatima Cody Stanford from Massachusetts General Hospital notes a striking statistic: nearly 70% of her patients lost insurance coverage for GLP-1 drugs this year due to their high costs. “They’re not stopping because they want to,” she explains; many are forced to transition away from treatments.
Dr. Stanford views long-lasting therapies like Rejuva as potential breakthroughs but also questions their feasibility, hinting that such solutions might still sound too good to be true.
Fractyl argues that although gene therapy comes with a hefty price tag, it could ultimately lead to better long-term health outcomes and cut down the need for ongoing medication. As they gear up for regulatory approvals and clinical trials, the medical community remains cautiously optimistic. If all goes well, Dr. Rajagopalan’s work may not just change individual lives but also transform the pharmaceutical landscape.
For more details on gene therapies, consider looking at The Washington Post’s coverage of the topic.
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