Muñaro, a new drug for diabetes and obesity, arrives in Spain, improving the results of existing drugs.

From July 1 next year A new medicine designed to treat type 2 diabetes and obesity will be available in Spanish pharmacies. This is Mujaroa drug developed by Lilly whose active ingredient, tirzepatide, has been shown to “enhance” the results of other similar drugs already on the market, such as Ozempic.

Leading experts in the field of endocrinology and nutrition took part in the presentation of the drug Munjaro, which is administered subcutaneously weekly in doses of 5 and 10 mg (currently available only in Spain). Although it is not yet funded by the public health system, Lilly is in discussions with the Department of Health about its inclusion. In this case, the monthly price of treatment will be 271 euros for a dose of 5 mg and 358 euros for a dose of 10 mg, and in both cases a doctor’s prescription is required.

Munjaro treatment is started in a stepwise manner, starting with a dose of 2.5 mg for the first 4 weeks and then increasing the dose to 5 mg. If the expected therapeutic goals are not achieved, the dose can be increased to 7.5 mg for an additional 4 weeks before finally moving to 10 mg, explained José Antonio Sacristan, medical director of Lilly Spain.

What distinguishes Mujaro from other similar drugs?

The main difference between tirzepatide, the active ingredient in Mugnaro, and semaglutide (present in drugs such as Ozempic or Vegovi) is their mechanism of action. While semaglutide only stimulates glucagon-like peptide 1 (GLP-1), tirzepatide also activates glucose-dependent insulinotropic peptide (GIP). This dual action is “what matters” and allows Muñaro to “strengthen” the results obtained with semaglutide, as explained by Javier Escalada, president of the Foundation of the Spanish Society of Endocrinology and Nutrition (FSEEN).

Mujaro Indications and results

Mujaro was approved for two main indications: for the treatment of type 2 diabeteswhich affects one in seven adults in Spain (the second highest rate in Europe), and for weight control in people with body mass index (BMI) over 27 who have at least one complication associated with excess weight or obesity (BMI over 30).

Thanks to its mechanism of action, Mujaro not only promotes glycemic control, but also reduces appetite, increases the feeling of satiety and reduces excess fat. In clinical studies conducted with tirzepatide in patients with diabetes, more than 90% achieved adequate glycemic control and more than half achieved normalization. (compared to 19.7% achieved with semaglutide). In addition, an average weight loss of up to 12.4 kg was observed, which was double that with semaglutide (6.2 kg).

In terms of effectiveness in overweight and obese people without diabetes, tirzepatide reduced an average of up to 22.5% (23.6 kg) of body weight after 72 weeks of treatment. Besides, 4 out of 10 patients achieved a loss equal to or greater than 25%, a figure achievable only with bariatric surgery. 96% of participants experienced weight loss equal to or greater than 5%. “Impressive” results were also observed when waist circumference was reduced to 20 cm.

Cardiometabolic Benefits and Side Effects of Munjaro

In addition to influencing glycemic control and weight loss, Mujaro demonstrated additional benefits on key cardiometabolic parameters. There was a significant reduction in triglyceride levels (24.3-31.4%), improvement in blood pressure (both systolic and diastolic) and a positive effect on the lipid profile (increased HDL cholesterol and decreased LDL).

Mar Malagon, president of the Spanish Society for the Fight against Obesity (Seedo), stressed that these drugs are indicated for “obviously sick people” and not for “casual weight loss.” Obesity is a chronic and multifactorial disease based on dysfunction of adipose tissue, affecting 18% of adults in Spain.. Malagon warns that changing the hormonal system without real need can lead to harmful long-term consequences.

Between Side effects of Mujaro include loss of muscle mass, which can and should be reduced with regular exercise. Other side effects are mild and similar to those when taking semaglutide, for example: nausea, diarrhea and vomiting. Only 4.2% of patients had to discontinue treatment due to these effects.

Contraindications and future research

Tirzepatide is contraindicated in people with a history of pancreatitis, as well as in pregnant women., as safety and effectiveness studies have not yet been conducted in this population. A recent study from the University of California, San Diego, demonstrated the potential of this drug as the first effective pharmacological treatment for obstructive sleep apnea, opening new avenues for research.