Potential Game-Changers in Weight Loss Drug Development

The pharmaceutical sector has been witnessing a surge in research and development (R&D) for weight-loss treatments, with drugs like Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound leading the charge. The market for glucagon-like peptide-1 (GLP-1) therapies is predicted to reach over $100 billion by 2030, as they are increasingly used in managing diabetes and obesity.

Analysts at J.P. Morgan and IQVIA have noted a significant rise in clinical trials for obesity medications. In 2023, there was a 68% increase from the previous year, with 124 drugs in development. Notably, 40% of these are GLP-1 or glucose-dependent insulinotropic peptide (GIP) receptor agonists.

Mizuho Americas' Graig Suvannavejh has pointed out that the industry is particularly interested in GLP-1-based therapies and is exploring combination therapies, such as Eli Lilly’s approach that targets GIP, GLP-1, and glucagon receptors simultaneously. The development of oral delivery systems for these drugs is also gaining attention, as it could reduce manufacturing costs and make treatments more accessible.

BioSpace has identified four treatments that could revolutionize the market. While the focus has been on injectable GIP/GLP-1 drugs, companies are also looking at innovative approaches.

Novo Nordisk is working on a once-weekly subcutaneous combination of semaglutide and cagrilintide, an amylin analog. This combination, known as CagriSema, is being compared to Eli Lilly’s Zepbound in a Phase III trial. In Phase II, the combination showed a significant reduction in body weight for overweight individuals with type II diabetes.

Eli Lilly is also advancing its weight-loss portfolio with orforglipron, a GLP-1 receptor agonist delivered orally once daily. The company aims to be the first to market with an oral treatment, which could be a game-changer due to manufacturing and patient preference advantages. Orforglipron has shown promising weight loss results in Phase II trials.

Viking Therapeutics has reported positive outcomes for its obesity candidate, VK2735, a dual GLP-1/GIP agonist. The drug has demonstrated significant weight loss in Phase II trials, and its oral formulation has also shown promising results in Phase I. The drug’s tolerability and low incidence of gastrointestinal side effects could set it apart from other GLP-1 medications.

Lastly, Inversago Pharma’s INV-202, a CB1 receptor blocker, has shown potential as an oral treatment for weight loss. Backed by Novo Nordisk, the drug has demonstrated average weight loss in a Phase Ib study. It is designed to target peripheral CB1 receptors, avoiding previous adverse events associated with this pathway.

These treatments could offer new combination approaches for patients who do not respond to GLP-1 or cannot tolerate its side effects, positioning them as significant contenders in the weight-loss market.