Exploring the Wide World of GLP-1s | AMCP Annual 2025

First, it was Type 2 diabetes. Then it was weight loss, and next, cardiovascular disease.

Still more possible uses of the glucagon-like peptide 1 (GLP-1) drugs were discussed this morning at a keynote session this morning on the last day of the annual meeting of the Academy of Managed Care Pharmacy (AMCP) in Houston.

Panelists Amy Lugo, Pharm.D., founder and CEO of LoneStar Health Solutions, LLC; Angela Allerman, Pharm.D., a clinical pharmacist from San Antonio, Texas; and Kristen Patti, Pharm.D., M.S., manager of clinical drug evaluation and policy at Blue Cross Blue Shield of Michigan, talked about the high-profile GLP-1s as treatments for obstructive sleep apnea, substance use disorder and Alzheimer’s disease. The results of the studies are mixed and preliminary, so far from conclusive.

Obstructive sleep apnea can be a complication of obesity, and for this reason, GLP-1s are being studied to improve obstructive sleep apnea symptoms, Lugo explained. Specifically, in the SURMOUNT study, tirzepatide reduced the apnea hypoxia index (AHI) score by 51% and weight by 17 to 20%. Eli Lilly markets tirzepatide under the brand name Mounjaro as a Type 2 diabetes drug and as Zepbound for weight loss. In addition to being a GLP-1 receptor agonist, tirzepatide is a glucose-dependent insulinotropic polypeptide (GIP) receptor agonist.

Allerman covered GLP-1s as a possible treatment for various types of substance use disorders, including those involving tobacco, cocaine and alcohol. “Only 4.5% of people 12 and older receive a treatment option for those disorders,” Lugo said. “Specifically for alcohol use disorder, 29 million people have self-reported alcohol use, but only 2% reported receiving medication. We definitely need to recognize more options in this particular area.”

Amy Lugo, Pharm.D.

But whether the GLP-1s can fill the need is unclear. Exenatide didn't help with alcohol use disorder in one study, noted Allerman. Exenatide was marketed as Byetta and Bydureon but has been taken off the market. In another study, researchers found that low doses of semaglutide did help with some aspects of alcohol use disorder. Novo Nordisk markets semaglutide as Ozempic for Type 2 diabetes and as Wegovy for weight loss.

Mixed results were also seen in Alzheimer’s patients taking GLP-1s for cognitive decline, Allerman explained. A significant increase in short-term memory was seen in obese patients treated with 1.8 mg of liraglutide with prediabetes or early Type 2 diabetes, but the same dose resulted in no significant cognitive improvements or change in the beta-amyloid plaques that some research suggests are a central feature of Alzheimer's disease pathology. Novo Nordisk markets liraglutide as Victoza for Type 2 diabetes and as Saxenda for weight loss. It is also available as a generic.

“Overall, we need more data, and we know at this time it will be unlikely for health organizations to engage [in GLP-1 use] for Alzheimer's,” Allerman said.

Angela Allerman, Pharm.D.

Patti presented an overview of the GLP-1 pipeline. She emphasized the need for larger and longer studies.

The session was moderated by Jeffery Larson, RPh, M.S., MBA, a clinical director at CVS Health.

Kristen Patti, Pharm.D., M.S.