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[서울=뉴스핌] 황숙혜 기자 = 당뇨병 환자들의 혈당 조절을 위한 약물의 핵심인 GLP-1이 비만 치료 효과를 앞세워 블록버스터로 부상한 가운데 암 치료 가능성까지 확인되면서 월가의 조명이 집중되고 있습니다. 일라이 릴리를 포함해 비만 치료를 위한 GLP-1 유사체 약물을 공급하는 제약사들이 또 한 차례 성장 모멘텀을 얻을 수 있다는 기대가 관련 업계와 투자자들 사이에 번지고 있는 모양새입니다. 본래 GLP-1은 췌장에 작용해 인슐린 분비를 촉진하고 혈당을 높이는 글루카곤 분비를 억제하는 호르몬입니다. 혈당이 올라갈 때 수치를 낮추는 기전을 가진 GLP-1은 위장 운동을 늦춰 음식물이 장내에 오래 머물도록 하는 한편 뇌의 포만 중추를 자극해 식욕을 억제하는 효과를 가진 것으로 입증되었습니다. GLP-1 유사체를 이용한 비만 치료제가 제조된 배경도 여기에 있습니다. GLP-1과 암의 연관 관계는 2024년부터 본격적으로 제기되었습니다. 호르몬이 체중 감량에 효과를 내는 만큼 비만과 관련성이 높은 암의 발병 위험을 낮추는 데 효과적일 수 있다는 의견이 제기된 것입니다. 대장암과 간암, 신장암, 췌장암, 유방암, 난소암 등 의학계는 10여 가지 암을 비만 관련 암으로 분류하고 있습니다. 최근까지 연구에서 사람들이 체중을 감량할 때 암을 포함한 여러 질병의 발병 위험이 줄어드는 것으로 나타난 데 이어 내분비학회 연례회의에서 발표된 연구에서 GLP-1 작용제가 보다 직접적으로 암세포에 작용한다는 사실이 확인되었습니다. 동물을 이용한 실험에서 GLP-1이 유방암 종양 크기를 축소시키는 것으로 확인되었다고 학회는 발표했습니다. GLP-1이 미국 식품의약청으로부터 항암제로 승인받기까지는 아직 갈 길이 멀지만 최근까지 연구 결과가 암 발생 예방 그리고 더 나아가 암 치료까지 가능성을 열었다는 데 월가는 의미를 두고 있습니다. 실제 항암 치료에 GLP-1이 적용되려면 동물에 이어 환자를 대상으로 수차례의 대규모 임상 시험을 실시해 효능과 안전성을 입증해야 하고, 최근까지 나온 연구 결과를 최종 목적지까지 가기 위한 초기 단계라고 볼 수 있습니다. 장거리 마라톤의 출발 선에서 첫 발을 뗀 상황이지만 시장 전문가들은 낙관적입니다. GLP-1이 단순히 당뇨병 치료 효과를 가져오는 데 그치지 않고 체중 감량과 암 치료 효과까지 기대할 수 있다는 사실만으로도 의미가 작지 않다는 얘기입니다. UBS는 보고서를 내고 GLP-1 의약품 판매 규모가 2023~2029년 사이 연평균 30% 급증하는 시나리오를 제시했습니다. 시장 조사 업체 그랜드 뷰 리서치는 보고서를 통해 북미 지역의 GLP-1 수용체 작용제 의약품 판매 규모가 2023년 280억 달러에서 2030년 1391억 달러로 급팽창할 것으로 내다봤습니다. 2024~2030년 사이 북미 지역에서만 연평균 25.7%의 성장을 기록하는 셈입니다. 일라이 릴리는 이미 시장 성장에 커다란 반사이익을 보고 있습니다. 2025년 1분기 업체의 매출액이 127억 달러로 전년 대비 45% 급증한 가운데 젭바운드와 마운자로의 매출 규모가 총 62억 달러로 절반 이상의 비중을 차지했습니다. 주요 외신에 따르면 일라이 릴리는 하루 한 번 복용하는 알약 형태의 GLP-1 의약품 개발을 위해 3상 임상시험까지 완료했습니다. 미 식품의약청의 승인을 받으면 약품을 당뇨병과 비만 치료용으로 공급한다는 계획입니다. 업체는 3상 임상시험 결과가 고무적이라고 발표했습니다. 오르포글리프론은 저분자 약물로, 오젬픽과 마운자로 등 주사제 형태의 약물에 비해 편의성이 높습니다. 모간 스탠리는 경구용 GLP-1이 게임체인저가 될 것이라며 낙관론을 펼쳤습니다. 오르포글리프론의 미 식약청 승인이 확실시되고, 본격적인 판매가 개시되면 기존 주사제 GLP-1 시장을 급속하게 침투할 것이라는 얘기입니다.
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GLP-1 agonists have been a breakthrough for the treatment of obesity, a global problem with serious health risks. While the benefits of these therapies are seen as outweighing the risks, there have been some concerns about the loss of muscle mass, particularly in older people using these drugs. iBio is developing next-generation obesity therapies that may be able to be used in combination with GLP-1 agonists or by themselves. Its lead experimental therapy is a myostatin inhibitor, part of a class of therapies that have been of interest to treat muscle wasting. We spoke to Martin Brenner, CEO and chief scientific officer of iBIO, about obesity, the limits of GLP-1 agonists, and the potential for myostatin inhibitors alone or in combination with GLP-1 agonists.
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