Wegovy GLP-1 pill now available; early vaccine delays predict missed MMR shots; pre-op stress tied to tougher recovery in older patients – Morning Medical Update

Wegovy pill brings first oral GLP-1 option to U.S. patients

Novo Nordisk’s pill version of Wegovy is now available at U.S. pharmacies, marking the first FDA-approved oral GLP-1 for chronic weight management. Approved in late December, the drug offers an alternative to weekly injections for patients with obesity or overweight and is also cleared to reduce the risk of heart attack and stroke in high-risk patients. Clinical trial data showed weight loss comparable to the injectable form, with patients losing about 13.6% of body weight over 64 weeks on the highest dose. The pill must be taken on an empty stomach and carries similar gastrointestinal side effects as injections. Novo Nordisk set a direct-to-consumer cash price starting at $149 per month for the lowest dose, while the list price remains $1,349 monthly, matching injectable Wegovy.

Early delays predict missed MMR shots

Children who fall behind on routine immunizations in the first months of life are far more likely to miss their first measles, mumps and rubella (MMR) vaccine altogether, according to a new study published in JAMA Network Open. Researchers analyzed electronic health record (EHR) data from more than 321,000 U.S. children with regular access to care and found that timely MMR vaccination peaked in 2021 at 79.9%, then declined to 76.9% by 2024, while the proportion receiving no MMR dose by age 2 rose to nearly 8%. The strongest predictors of missing MMR were delayed 2- and 4-month vaccines, which were associated with roughly six- to sevenfold higher odds of nonvaccination.

Pre-op stress tied to tougher recovery in older patients

Even relatively mild worries before surgery may set older adults up for a harder recovery, according to a new Duke University study published in Anesthesiology. Researchers found that patients who brought more stressors into the operating room were more likely to develop postoperative delirium, report poorly controlled pain and stay in the hospital longer — even if they didn’t consider themselves highly stressed. More than 40% of older adults preparing for major noncardiac, non-neurologic surgery reported moderate to high distress, and each additional stressor increased the odds of delirium by 19%. The findings suggest a simple preoperative stress screening, which took just a few minutes to complete, could help clinicians identify patients who might benefit from added support before surgery.