More Gossip on Belviq and T2D
I only say gossip because I don't know if this person is a doctor
though he does sound convincing.
From Yahoo:
My Patient Population
I have been in practice for 30+ years; Internal Medicine is my specialty; Using the present parameters to prescribe Belviq, 70% of my patient population qualifies for this drug; Some of my patients have already contacted their insurance companies and from what they tell me, it's just a matter of their co-pay; When Belvig is released, I can assure the board I will be writing a tad more than 3 Rx's / month;
The beauty of this drug will not be weight loss but rather it's capability in lowering HbA1C values; Most obese patients are either diabetic, pre-diabetic, metabolic syndrome - whatever;
Here's a question for the board - hypothetical case but very common; 55 yr old female with a HbA1C of 8.0; She is 250 lbs, and on a variety of meds; We start Belviq with no change in any of her meds; 3 months later she comes in and weighs 249 lbs; Her HbA1C is now 7.1 - is she a "non -responder"?; Do I now stop this med? The answer is quite obvious; This is a new class of diabetic medications - period;
As I have said before, this is only the beginning for this company given their pipeline; I can wait basically almost forever; I do not need ARNA to skyrocket in order to retire or even slow down; For those who do, I suggest patience; And to those who think that "big money" always wins, in this particular case I think not;
Why? - They may have the money but I have the knowledge of the science; In fact, I would rather they shake out the uninformed;
The only problem I have with ARNA shares not appreciating more rapidly is not ARNA - it's the market itself;
With all that is happening in this world and our Country, along with this soaring stock market, will there be enough time to reap ARNA benefits? - I hope I'm wrong but fear I'm right;
mirror_world_man •
Reply How do % HbA1C reductions seen with Belviq observed in the trials compare to other agents you use and what are your thoughts on combining therapy with other agents for this indication?
Sentiment: Strong Buy
3 Replies to mirror_world_man
doctorb339 •
About the same - 0.9%; Do I think it should be a first line agent? - No;
But then again (and this is heresy folks) neither do I think metformin should be a first line agent; THE only reason metformin is first line is COST; BTW, do you know which oral diabetic drug preserves pancreatic beta cell function the longest?
That "bladder cancer" TZD drug - actos;
So what should be the first line agent for Type AODM - GLP agonists period; DPP4s - I'm not too keen about; Diabetics in general do not produce enough intestinal peptide to "inhibit"; Do I use them - yes;
So where does Belviq fit into this algorithm? Metformin is not going away; So it is still first line; Second line now becomes DPP4s, GLPs and Belvq (off label - at least for now); Will a patient want to inject? - If so, then GLPs are the way to go (and would be my strong recommendation); After that then you have the DPP4s,TZDs, and Belviq; But wait, there is a new kid on the block - the SGLT2 blockers; Being an old war horse, peeing glucose was bad now it may be good; Confusion abounds;
Bottom line - Belviq will be another medication in the regimen; Will be second line when ARNA decides to apply for this indication; Will compete with DPP4s, TZDs at the very least; It will not compete with GLPs unless mechanisms are more defined as to how Belviq works in lowering HbA1C levels ( ie gastric emptying, glucagon effects); Does it effect leptin/adiponectin levels, help preserve beta cells preservation? If some of these questions are answered and positive, Belviq moves up the food chain;
Hope this helps; If your more confused - welcome to my world;
Sincerely,
Doctorb
BTW in my opinion, the best non-insulin regimen for a type II diabetic, is Metformin, Actos, and a GLP ( I prefer Victoza); Reference Dr. DeFranzo -
IMHO "The guru" in type II AODM; Less
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