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Semaglutide initiation is associated with a lower risk for adult-onset epilepsy or seizures among adults with type 2 diabetes mellitus, according to study results presented at the American Academy of Neurology (AAN) Annual Meeting, held in Chicago, IL, from April 18 to 22, 2026.

Adults with type 2 diabetes mellitus have an elevated risk for seizures and epilepsy, potentially driven by inflammatory processes affecting the central nervous system. Beyond glucose regulation, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been explored for potential neurologic effects, though their influence on seizure risk remains unclear.

Researchers conducted a retrospective active-comparator, new-user target trial emulation using the National Institutes of Health All of Us Controlled Tier Dataset. The study included adults aged 18 years and older with type 2 diabetes mellitus who newly initiated semaglutide, sodium-glucose cotransporter-2 inhibitors (SGLT2i), or other glucose-lowering therapies between December 2018 and December 2021, with follow-up through December 2023. Inverse probability of treatment weighting was used to balance baseline characteristics, and time-to-event analyses were performed.

Among 393,596 eligible individuals, 8533 comprised the semaglutide vs glucose-lowering drug cohort (n=2397 vs n=6136), and 7455 comprised the semaglutide vs SGLT2i cohort (n=1650 vs n=3725).

After adjustment, semaglutide initiation was associated with a reduced risk for epilepsy or seizures compared with both glucose-lowering drugs (hazard ratio [HR], 0.46; 95% CI, 0.25–0.83; P =.010) and SGLT2i (HR, 0.44; 95% CI, 0.22–0.86; P =.017).

Additional modeling showed absolute risk reductions of -0.014 (number needed to treat [NNT], 69; P <.001) relative to glucose-lowering drugs and -0.008 (NNT, 129; P <.001) relative to SGLT2i.

Mediation analyses suggested that glycated hemoglobin accounted for only a small proportion of the observed association, contributing 1.1% of the effect in the comparison with glucose-lowering drugs and 3.6% in the comparison with SGLT2is, while body mass index contributed 0.3% or less in both comparisons.

We spoke with Yoonhyuk Jang, MD, PhD, Postdoctoral Fellow, Department of Immunology, Harvard Medical School, who noted, “This study suggests that semaglutide may be associated with a lower risk of adult-onset seizures or epilepsy in patients with type 2 diabetes, with the signal appearing more pronounced in late-onset cases among adults aged 60 years or older.”

He continued, “Given that age-associated brain insults are major contributors to adult-onset seizures and epilepsy, these findings may have implications beyond seizure risk alone and raise the possibility that semaglutide could also be relevant to broader brain health; however, because this was a retrospective target trial emulation with a relatively small number of events, it is not yet practice-changing and should instead be viewed as a signal that supports further research into the role of GLP-1 receptor agonists in epileptogenesis.”

Bagsværd, Denmark, 20 April 2026 – Novo Nordisk today announced the topline results from HIBISCUS, a pivotal phase 3 trial of once-daily oral etavopivat in adults and adolescents with sickle cell disease (SCD). The results showed that etavopivat successfully met both co-primary endpoints, demonstrating superior reduction in vaso-occlusive crises (VOCs) and superior improvement in haemoglobin (Hb) response compared to placebo.

Etavopivat is an oral, once-daily, pyruvate kinase-R (PKR) activator being developed to treat SCD, a seriously debilitating, life-threatening and life-shortening disease that impacts around 8 million people worldwide.

The HIBISCUS trial was a randomised, double-blinded, 52-week efficacy and safety trial investigating etavopivat 400 mg versus placebo in 385 people aged 12 years or older with SCD. Participants were allowed to receive standard of care treatment throughout the trial.

In the trial1, people treated with etavopivat demonstrated a superior reduction in the annualised rate of VOCs of 27% compared to placebo. The time to first VOC was significantly prolonged with etavopivat, with a median time to first VOC of 38.4 weeks versus 20.9 weeks for placebo.

In addition, etavopivat demonstrated a superior increase in the proportion of people achieving a Hb response greater than 1g/dL at week 24 of 48.7% compared to 7.2% with placebo, corresponding to an adjusted rate difference of 41.2%1. Further, as an exploratory analysis, etavopivat significantly reduced the risk of blood transfusion.

In the trial, etavopivat appeared to be well tolerated, with a topline safety profile in line with previous etavopivat trials.

“Sickle cell disease severely impacts the lives of millions of people. We are very excited that etavopivat has the potential to be a first and best-in-class therapy and transform the lives of people with sickle cell disease, who currently have limited therapeutic options,” said Martin Holst Lange, executive vice president, chief scientific officer and head of Research and Development at Novo Nordisk. “Novo Nordisk remains committed to collaborating with sickle cell disease communities around the world to drive innovation, advance health equity and improve access to treatment and care.”

Novo Nordisk plans to submit for the first regulatory approval of etavopivat in the second half of 2026. The detailed results from the HIBISCUS phase 3 trial will be presented at a scientific conference in 2026.

Insulin

Novo Nordisk states that it will resume supplying human insulin to the Brazilian public health system (SUS) if the Ministry of Health signs a contract by the end of May. The ministry, headed by Alexandre Padilha, says it will open a bidding process in the coming months for the purchase of the medication used to control diabetes.

The Danish pharmaceutical company has reduced deliveries to the public healthcare system in recent years and announced it would stop manufacturing the product by the end of 2026. This market shift coincided with a portfolio restructuring by major insulin manufacturers, who began focusing on weight-loss medications. In the case of Novo Nordisk, its strongest product is Ozempic.

The market shift has had a strong impact on the supply of insulin in the public healthcare system and the Farmácia Popular program. The SUS (Brazilian public healthcare system) has faced cycles of shortages since at least 2023. To circumvent the scarcity in the local market, the ministry began purchasing medications without registration from Anvisa (National Health Surveillance Agency), mainly imported from China.

However, purchasing these products without registration raises criticism from the national industry and questions from medical societies about the quality of these products.

Novo Nordisk's proposal is to sell 100 million to 125 million insulin pens from July 2026 to March 2028, produced at its factory in Montes Claros (MG). Considering the company's latest public contract values, the purchase would cost more than R$ 1.5 billion.

The pharmaceutical company says it will maintain its plan to halt production of this type of insulin by the end of 2026 if no agreement is reached with the Lula (PT) government. The company's statement was delivered to the Ministry of Health and to CONASEMS (National Council of Municipal Health Secretariats).

Eurofarma (Novo Nordisk's partner in Brazil)

Eurofarma announced this Thursday (April 16th) a patient program that will offer semaglutide at reduced prices. The pharmaceutical company launched the injectable original biological semaglutide brands Poviztra® and Extensior® in October 2025, in partnership with Novo Nordisk. With the program, the dosages of the medications should become up to 17% more affordable.

The program integrates the launch of EuroCuida (EuroCares), developed to offer more accessible and continuous care. In addition to price reductions, according to Eurofarma, the initiative seeks to encourage the initiation, adherence, and continuity of treatments. The goal is to expand access to treatment for obesity, overweight associated with comorbidities, and type 2 diabetes for the Brazilian population.

In addition to reduced fixed prices for all semaglutide dosages, EuroCuida (Eurocares) also aims to expand access to treatment initiation.

April 16, 2026

The medicine sales data of Indian Pharmaceutical Market (IPM) analysed by market intelligence firm Pharmatrac shows that for the month of March, Novo Nordish managed to hold its ground despite launch of multiple generic brands of GLP 1 agonist semaglutide during the last 10 days of March.

Danish drug major Novo Nordisk seems to be withstanding stiff competition from generic players after its global blockbuster diabetes and weight loss drug semaglutide lost patent protection in India on March 20. Post patent-expiry, 26 brands from 13 companies, including Novo Nordisk, are being marketed in India.

The India revenue from Novo Nordisk’s three semaglutide brands – Rybelsus (oral formulation) and Wegovy and Ozempic (injectables) – together was Rs 45 crore in March, less than Rs 47 crore in February 2026, despite generic competition in March, Pharmatrac data shows. Generic semaglutide brands from Torrent fetched Rs 4.7 crore in revenue, while Dr Reddy’s Labs’ brands together garnered Rs 1.9 crore in March. Zydus Healthcare and Lupin both saw their semaglutide brands garner Rs 1.4 crore each last month. The sales numbers indicate market expansion, while Novo Nordisk brands managing to ward off the competition to some extent.

In an industry presentation, Pharmatrac analyst Sheetal Sapale said innovator driven efficacy, increased share of voice due to partnerships with pharma companies Emcure and Abbott and bringing the pricing at par with some key generics may play a significant role in future for the Novo Nordisk in the semaglutide market.

“Some more aggressive launches may be seen in the next few days. Exponential growth phenomenon may be repeated for the month of April 26 as well”, she said.

Incidentally, the patent expiry of semaglutide has impacted the sales of the market leader in GLP-1 class of medicines - tirzepatide of Eli Lilly. Lilly’s molecule which is still under patent protection in India saw its sales dip 21% to Rs 114 crore in March, as compared to Rs 135 crore in February 2026. This is the first time tirzepatide has shown a drop in sales ever since it was launched in March 2025. Top 10 players in the overall Indian GLP-1 agonist market are Eli Lilly, Novo Nordisk, Cipla, Torrent, Lupin, Eris, Dr Reddys, Zydus Healthcare, Glenmark and Sun Pharma, Pharmatrac data shows.

According to Bloomberg, the latest recruitment drive reflects a more targeted approach to workforce planning, with Novo Nordisk focusing on strengthening capabilities in priority areas rather than pursuing across-the-board expansion. The company is said to be hiring in functions aligned with its long-term growth strategy, even as it maintains tighter cost controls following last year’s reductions.

The restructuring comes at a time when Novo Nordisk is navigating market dynamics, including rising global demand for weight-loss treatments and intensifying competition from rivals developing similar therapies. Its obesity drugs, which have seen surging demand in recent years, remain central to its growth ambitions, prompting the company to realign its workforce to better support production, research, and commercialization efforts.

Bloomberg reported that the company’s workforce overhaul is part of Doustdar’s broader push to improve efficiency while ensuring that Novo Nordisk remains competitive in a rapidly evolving pharmaceutical landscape. By trimming roles in some areas and expanding in others, the company appears to be recalibrating its organisational structure to match changing business priorities.

April 15, 2026.

More than a year after U.S. Food and Drug Administration approval of semaglutide (Ozempic®) to reduce the risk of kidney disease progression, kidney failure, and cardiovascular death in adults with type 2 diabetes (T2D) and chronic kidney disease (CKD), its impact on clinical practice is becoming increasingly evident.

According to Rute Paixao, MD, a board-certified nephrologist with Cleveland Clinic in Florida, the therapy has already begun to reshape referral patterns and treatment strategies.

“Patients are increasingly requesting Ozempic by name, often prompted by media exposure or counseling from primary care providers about a medication that may help protect kidney function,” she says.

Clinical Utility

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) exert multiple effects relevant to CKD progression, including reductions in blood pressure, systemic inflammation, and albuminuria, as well as clinically meaningful weight loss.

Dr. Paixao describes semaglutide as an important addition to the nephrology armamentarium that complements, rather than replaces, established therapies. Reflecting its growing role, GLP-1–based therapies have been incorporated into the nephrology fellowship curriculum at Cleveland Clinic in Florida.

Positioning within CKD treatment algorithms

Semaglutide should be incorporated within a stepwise, guideline-aligned treatment strategy for patients with diabetes-related CKD.

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These agents act through complementary mechanisms to preserve renal function. Within this framework, semaglutide is best considered an add-on therapy rather than a replacement for established treatments.

Dr. Paixao also notes potential implications for kidney transplant eligibility. Because many transplant programs require a body mass index (BMI) below 30 to 35, weight loss associated with GLP-1 therapy may help more patients qualify for transplantation while simultaneously delaying disease progression.

(Continues...)

Anagni – March 28, 2026

A handshake, a few hours of discussion with management, and news that restores hope to hundreds of families: Novo Nordisk is returning to bet on Anagni. Yesterday, Friday, March 27, 2026, Erik Lorin Rasmussen, Vice President of the Danish pharmaceutical giant, passed through the gates of the plant located in the heart of the Anagni industrial zone for a meeting with the site’s leadership. The message brought from Copenhagen leaves no room for interpretation: from May, operations restart, with an investment of one billion euros and zero risk for workers.

The "Cold Shower" of Summer 2025

To understand the significance of this visit, one must look back. In August 2025, the Anagni plant suffered a sudden stop in the production of Wegovy—the semaglutide-based drug that quickly became the symbol of the new frontier in the fight against obesity—and found itself operating exclusively as a contract manufacturer for Bristol Myers Squibb. It was a drastic reduction, almost a silent "demotion" for a site that aimed for a much larger role in the group’s global supply chain.

The origin of that slowdown was a mix of factors: the Catalent operation (where Novo Nordisk acquired the American manufacturer) was finalized in December 2024, but then the market shifted.

Competition, Tariffs, and a Changing Market

New competitors began appearing in the weight-loss market, eroding the competitive advantage Novo Nordisk had built with Wegovy and Ozempic. To complicate matters further, tariffs pushed by Donald Trump on pharmaceutical products manufactured outside the United States forced the Danish group into a deep re-evaluation of its global industrial strategy.

The result was a difficult choice: of the group’s three global plants—Anagni, one in Brussels (Belgium), and one in Bloomington (Indiana)—only the U.S. plant continued production without interruption. The other two were "paused."

The Relaunch: One Billion and No Redundancies

Now, the tune has changed. Rasmussen’s visit to Anagni is the most concrete signal that Novo Nordisk has no intention of abandoning the area. The announcement is clear: from May, regular production of anti-obesity drugs will resume, supported by a total investment of one billion euros. Importantly for the staff, no layoffs or personnel reductions are planned.

This is a major signal not just for the direct employees, but for the entire local economy. Anagni, historically linked to the pharmaceutical industry, can look to the future with renewed confidence.