Expanding Therapeutic Roles for GLP-1 Medications
In this interview, Daniel Drucker, OC, MD, FRCPC, FRSC, FRS, clinician scientist at the Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital in Toronto, previews his American Association of Clinical Endocrinology (AACE) 2025 Annual Meeting presentation on the expanding potential of GLP-1–based therapies. He discusses the growing pipeline of GLP-1 molecules, new indications in diseases such as heart failure, kidney disease, and Alzheimer’s, and the importance of evaluating safety, efficacy, and cost-effectiveness as these agents enter broader clinical use.
Reference:
- Drucker, Daniel. Endocrine innovation & obesity breakthroughs. Talk presented at: American Association of Clinical Endocrinology 2025 Annual Meeting; May 15, 2025; Orlando, FL. Accessed May 6, 2025. https://am.aace.com/
TRANSCRIPTION
Daniel Drucker, OC, MD, FRCPC, FRSC, FRS: Hi, my name is Daniel Drucker. I'm a clinician scientist at the Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital in Toronto, and I'll be speaking at AACE on the new world of GLP-1 medicine and what the horizon looks like.
Consultant360: What are the key themes of your presentation?
Dr Drucker: So we've had 20 years of GLP-1 medicines. And as we sit here now and look to the future, we can legitimately say: What comes next?
I think the themes of looking at the future are the new molecules—of which there are dozens under development—and then new indications. You know, we've seen this medicine go from type 2 diabetes to weight loss and people living with obesity, to heart disease and kidney disease and arthritis and metabolic liver disease and sleep apnea. A whole range of conditions are being explored, which are really exciting, and we'll discuss what the future might look like in that regard.
C360: Why is this topic particularly relevant right now?
Dr Drucker: We know that when we are seeing people in the office living with type 2 diabetes, living with obesity, what we're really trying to do is make them healthier and prevent them from medications. And that's what GLP-1 medicines seem to do.
Clinicians, I think, are quite excited by the opportunity to expand the benefits of the health care they provide—not just from controlling blood sugar, not by simply losing a few pounds, but saying, hey, you're going to get less kidney disease. You're going to have fewer problems with your breathing. Your heart failure might be better. You might have a lower chance of having a heart attack or a stroke. Maybe you'll have a reduced risk of developing Alzheimer's disease—we don't know. The trials are underway. So these are really wonderful opportunities for health care providers to improve health and for patients living with these disorders to be healthier.
C360: What are the most important takeaways for clinicians in practice?
Dr Drucker: I think the real important takeaways are: What is the risk-benefit value proposition for each of the conditions? And what do we need to know about how to use the medicines—who is the right population, what are the side effects, are there any adverse effects unique to the different conditions we've discussed?
So there's still a lot to think about, but it's an exciting opportunity to really learn a lot about how to wisely use GLP-1 medicines to have a greater chance of making a big impact and improving health.
C360: What gaps in knowledge or areas for future research would you like to see further explored around GLP-1s?
Dr Drucker: I'm a big fan of understanding safety. Every time we have a new molecule, we're starting again. We don't have 20 years of safety. We have 20 years of safety with the GLP-1 class in type 2 diabetes. Every time we bring a new molecular entity to the clinic—and there are lots coming—we need to start again and say, is this safe? How does this work? What should we be looking for?
And then, you know, the medicines are expensive. How do we wisely use them to get the greatest bang for our buck and the greatest improvement in health? We have to look critically at the trials and say, is the effect size really worth it? Which population really benefited the most? How do we target the most wise use of these medicines to the people who would need and benefit the most?
These are really exciting areas for research going forward. I think this is a tremendously exciting time to be working in metabolic medicine, and for the young people just getting started, there are fantastic opportunities for basic science research, for clinical research, and ultimately the answers to those questions are going to, I think, further allow us to improve the health of the patients that we see—which is why we walk in the door every day.