How Cortisol-Targeted Approaches Might be Paired with GLP-1 Medications

GLP-1 medications might be most well-known as weight-loss options, but they were originally developed as a treatment for type 2 diabetes. For many patients, the drugs remain a highly effective treatment for the condition.

However, GLP-1s are not perfect and don’t work for every patient. In April of this year, Pharmaceutical Executive spoke with Mark Bagnall, CEO of Phenomix, discussed various reasons why a significant number of patients go off the medication within the first year of using it. His discussion focused on how side effects can be severe and incapitating, while the results can be inconsistent.

Pharmaceutical Executive recently spoke with Dr. Elena Christofides, scientific/medical advisor for Sparrow Pharmaceuticals, about a different issue some GLP-1 users face. Specifically, patients with high cortisol levels face unique challenges that GLP-1s may not be able to tackle.

Pharmaceutical Executive: How might cortisol-targeted approached be paired with GLP-1 medications?
Dr. Elena Christofides: Diabetes is a complex disease, and when treating it we operate from assumptions about how a patient will respond to prescribed medications based on clinical trial averages. When a patient doesn't respond as expected, that is the signal to think about alternative diagnoses that could be negatively influencing their glucose control or undermining the effectiveness of their medications.

That is the point at which we begin screening for cortisol disruption. By identifying it and adding cortisol-regulating medications to the regimen, we can address the true underlying pathology — the pathology that may have contributed to the patient's diabetes in the first place, that may be driving their hypoglycemia, or that is at minimum significantly limiting the effectiveness of the medications we've already prescribed. The goal is to remove the barrier that is preventing the patient from achieving the outcomes we would expect from that class of medications.