Amazing medicines for obesity Wegovi and Zepbound are already showing they can reduce the risk of heart and chronic kidney disease in addition to helping people lose weight. Now, a US-wide trial will test whether tirazeptide, the active ingredient in Zepbound, can be an effective treatment for people with long-term Covid.
Part of a class of drugs called GLP-1s, tirazeptide acts on receptors in the gut and brain to regulate appetite. As a result, people lose weight by eating less. But losing body weight does not fully explain the positive effects on the heart and kidneys. Growing evidence suggests the drugs have broad anti-inflammatory effects on the body – a mechanism that is of interest for treating long Covid.
At least 20 million people in the US have experienced long Covid, a chronic condition that lasts for at least three months after the initial infection. While over 200 symptoms of Long Covid have been documented, some of the most common include cough, shortness of breath, brain fog, fatigue, mood swings, trouble sleeping and body aches.
Scientists still don’t fully understand how and why long COVID occurs, but they have found persistent inflammation in many patients. This chronic inflammation can be caused by lingering traces of the virus in the body or by misdirected antibodies, known as autoantibodies, that attack a person’s own cells and tissues. There is hope that tirazeptide can reduce this inflammation to improve patients’ symptoms.
“The rationale for the GLP-1 drug is its powerful body-wide and brain anti-inflammatory properties,” says Eric Topol, MD, a cardiologist and director of the California-based Scripps Research Translational Institute, which is sponsoring the trial.
Scripps researchers are recruiting 1,000 people nationwide who are 18 years of age or older and have medically documented long-term COVID. Unlike most medical studies, which typically require multiple in-person visits, the Scripps trial is completely remote. Participants will be randomized by mail to receive tirazepide or placebo and will take it for one year. They’ll get a fitness tracker so researchers can measure their step count, which is an important indicator of fatigue. Participants will also receive a smart scale and will weigh themselves regularly. Since GLP-1 is used for weight management, study investigators wanted to make sure participants did not lose too much weight during the trial.
The trial’s co-principal investigator Julia Moore Vogel, herself a long-term COVID sufferer, says the trial’s remote design was intentional. “For the long COVID population, this is very important, because if you are asking people to come to the clinic, you are systematically excluding the most severely affected people who are homebound or bedridden. It was really important for us to make sure that those people were included.”