Potential new market for Tesamorelin
I have to warn there are many estimates in this post but I just wanted to get an idea about the potentials of approaching/motivating HIV patients to get started on Tesamorelin not only for lipodystrophy but regaining muscle loss caused by weight loss drugs.
Muscle increases after taking Tesamorelin:
"Compared to placebo, tesamorelin resulted in significantly greater increases in muscle density across in total muscle groups and in the lean anterolateral/abdominal and rectus muscle, even after adjusting for differences at baseline."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766405/
Dr. Grinspoon, Dr. Stanley and Christian are among the writers.
Obesity among HIV patients on ART:
"Among PWH in our cohort, 35.5% were overweight and 17.9% were obese at baseline, aligning more closely with the prevalence of high BMI in the general population...In the first 2 years after ART initiation, BMI increased on average >4 times as fast for PWH (0.53 per year) vs PWoH (0.12 per year). "
So before starting ART the prevalence of obesity among PLWH and PLWoH(general population) was similar however HIV patients who were initiated on ART gained weight much faster than general population in the first couple of years on the medications!
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10846771/
Muscle loss after taking obesity medication:
“Of this subset, the total mass loss was nearly 14 kg and while nearly 8.5 kg (about 60%) was fat loss, the 5 kg lean mass loss reported was 38%, which is on the high end of what we’d expect,”
Ozempic May Make Your Muscles and Bones Weaker
So about 40 percent of the total weight loss was muscle mass which is significant specifically among older and aging PLWH.
HIV Statistics:
"1.2 million people in the United States aged 13 and older had HIV in the U.S....
about 75% received some HIV care, 54% were retained in care, and 66% were virally suppresse"
https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics
Currently there are estimated 1.2 million HIV positive people in the US some 54% retained on ART so about 650000 patients.
Some 18 percent are obese before starting treatment but that number increases progressively/gradually during the first two years on antivirals.
Even if we use 18%, 0.18X65000= 117000 PLWH are obese.
Projected US population on weight loss drugs:
"New research from Goldman Sachs projects 15 million adults in the US will be on anti-obesity medications by 2030, representing 13% penetration in the US adult population — not including diabetic patients."
https://finance.yahoo.com/news/goldman-15-million-americans-will-be-taking-weight-loss-drugs-by-2030-193750289.html
So let's put these numbers in perspective for the future(2030)addressable market for Tesamorelin among obese HIV patients who will take weight loss drugs,117000X0.13=15210.
Point is there will be a market to approach apart from lipodystrophy for Tesamorelin addressing muscle loss caused by those weight loss drugs and who knows maybe that market is easier to penetrate than lipodystrophy because as crazy as it sounds it could be harder to motivate patients starting Tesamorelin because of further metabolic health risks than regaining muscle mass so they can start and keep using weight loss drugs and not worrying about muscle loss.