Chronic disease is, by its very definition, omnipresent. But changes year to year have the potential to make certain conditions into flaming-red targets for researchers and pharmaceutical companies.
Last year was one for obesity, marked by new – and for the first time, highly effective – weight loss drugs that demonstrated other health benefits.
But the question is whether that wave of interest will persist into the new year, or transfer to some other condition – maybe some liver diseases that are troublingly increasing, reports STAT News, which has listed three possible predictions relating to chronic disease in 2024.
Obesity revolution enters new phase
This year will be all about the new generation of obesity drugs’ performance on the big stage. Can drugmakers bolster evidence of the efficacy and benefit of the GLP-1 based drugs like Wegovy and Zepbound? Will new therapies emerge (companies like Pfizer are already running into barriers developing an oral drug)?
Will insurance coverage expand in the wake of positive data, like the SELECT trial results that showed Wegovy mitigated the risk of major heart problems?
Data from a SELECT follow-up study might show whether Wegovy can prevent Type 2 diabetes. Burgeoning research on the multifactorial roots of obesity and food craving could also offer a better understanding of how we got here in the first place, and guidance for more targeted therapies.
Above all, as the public shifts attention toward new shiny objects, will people continue to seek the drugs out and adhere to them, and will clinicians see them as a reliable medical tool? Their decisions will determine if the market will become as sprawling as some analysts predicted, or if the treatments just become another example of the pharmaceutical boom-and-bust cycle.
Climate effects on chronic diseases
Coming off the hottest year on human record, and with some experts predicting an even-hotter 2024, our eyes are on the health implications of climate change.
Heat kills more people each year than any other weather-related event. Hot days also take a toll on mental health, and can increase the odds of being injured at work, or having a heart attack or an infection, straining emergency departments. Heat can also set off flare-ups of various chronic health conditions.
Mounting evidence shows how prolonged and extreme heat exposure harms the health of workers – including farmworkers, construction, factory and warehouse staff. And many of the millions of people living with chronic conditions have layers of vulnerability to very hot days, air pollution and environmental toxins. We expect to see more research in the area in 2024, and maybe some innovative steps to protect people from climate hazards.
As climate shocks and natural disasters, like tornadoes and wildfires, grow increasingly common, people with chronic diseases are also exposed to lapses in access to care, medication, and the day-to-day tools and services on which they rely to manage their conditions.
Liver disease arising in younger people
Liver doctors have been sounding an alarm for several years now: rates of liver disease are rising, especially among women and younger people. After a long crusade against hepatitis-induced liver injury and disease, the field is now facing dual threats of liver disease driven by metabolic disorders and alcohol.
Still, transplant is usually the only option for the large population of people with the most common forms of liver disease. And the costs to the healthcare system are similarly huge: it’s estimated about $100bn in annual medical costs are directly linked to what was formerly called fatty liver disease.
To strip these conditions of some stigma and make the nomenclature more accurate, national liver groups decided last year to change the names of several liver conditions.
What was previously dubbed non-alcoholic fatty liver disease, or NAFLD, is now metabolic dysfunction-associated steatotic liver disease, or MASLD. And non-alcoholic steatohepatitis, or NASH, should be called MASH: metabolic dysfunction-associated steatohepatitis.
There are other signs that the largest internal organ is getting more attention. In 2023, the ADA recommended that all diabetes patients be screened for MASLD. Cases of MASLD in children are of growing concern among paediatricians. And pharmaceutical interest in MASH is growing.
Despite failed trials and the US FDA’s rejection in 2023 of a MASH drug from Intercept, several therapies are in the pipeline (including one by Madrigal that’s expected to go before the FDA soon).
Researchers are also studying whether GLP-1-related medications might help people with MASH.
See more from MedicalBrief archives:
Weight-loss drugs frenzy risks return of body size stigma
Weight loss drug trial suggests significant heart benefit
NAFLD and cardiovascular risk – American Heart Association scientific statement
Global warming linked to likely increase in violent deaths
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