Eli Lilly Obesity Pills Maintain Weight Loss After Wegovy and Zepbound

Eli Lilly She said Thursday that the closely watched obesity pill helped patients keep off the majority of the weight they lost after they switched directly from taking the company’s Zepbound injections and Novo NordiskWegovy was shot by his rival late in the trial.

The company also said it has applied for FDA approval for its daily GLP-1 pill, called orforglipron, to treat obesity. The FDA said in November that it had granted a priority review voucher for these pills, which could speed up the review timeline by a few months.

Positive trial data suggests that the pill could be an effective treatment for patients who switch to it if they want to maintain weight loss but do not want to take weekly injections long-term. Many people who stop these doses regain much of the weight they initially lost.

While Eli Lilly’s pills appear to cause less weight loss overall than existing injections, Thursday’s results highlight their potential role as a needle-free maintenance treatment in the blockbuster GLP-1 market. But an oral obesity pill from Novo Nordisk is likely to hit the market first, giving the Danish pharmaceutical company a head start in asserting its claim in this area.

The phase 3 trial followed more than 300 patients with obesity who had previously taken Wegovy or Zepbound for 72 weeks in a separate late-stage study. These people were then randomized to take Eli Lilly pills or a placebo for another 52 weeks. The oral drug met the trial’s primary goal of demonstrating superior weight loss maintenance compared with placebo, among people who had previously experienced plateaus in their progress while taking the injection.

On average, patients who switched to the pill from Novo Nordisk’s Wegovy regained about 2 pounds of the weight they initially lost by the end of the trial. Meanwhile, on average, people who switched to Zepbound birth control pills regained about 11 pounds of the weight they initially lost by the end of the study.

“Obesity is a chronic, progressive disease, and sustained weight loss remains a major challenge for many,” Kenneth Caster, MD, president of Lilly Cardiometabolic Health, said in a statement.

He said the trial showed that the pill “helped people maintain the weight they had worked so hard to lose”, and that if approved, it could “provide a suitable alternative for millions of obese individuals around the world to continue their long-term health journey”.

While people in the Zepbound group appeared to regain more weight, the greater focus was likely on those who switched from the drug’s biggest competitor, Wegovy.

In an October note, BMO Capital Markets analyst Evan Segerman said positive results from the trial could give Eli Lilly a “unique opportunity to capture revenue share” of chronic treatment with semaglutide, the active ingredient in Novo Nordisk’s Wegovy and Ozempic diabetes injection.

“Reducing the potential of Novo’s flagship product,” Segerman wrote.

The overall safety and tolerability — or how well patients cope with treatment — of the pill was consistent with previous late-stage studies. The most common side effects were gastrointestinal related and were generally mild to moderate.

About 4.8% of people who switched to the pill from Wegovy stopped treatment because of side effects, while 7.2% of those who switched to the oral medication from Zepbound did the same. Meanwhile, these rates were 7.6% and 6.3% among patients who switched to placebo from Wegovy and Zepbound, respectively.

No liver safety issues were observed, according to Eli Lilly. The full results of the trial, called ATTAIN-MAINTAIN, will be presented at an upcoming medical meeting and published in a peer-reviewed journal next year.

Eli Lilly’s pill works in a similar way to a diabetes pill made by Wegovy, Ozempic and Novo Nordisk, Rybelsus, in that it targets an intestinal hormone called GLP-1 to suppress a person’s appetite and regulate blood sugar. Novo Nordisk is also seeking approval for an oral version of Wegovy for the treatment of obesity, which could come by the end of the year.

But unlike those three treatments, Eli Lilly’s pills are not a peptide drug. This means that it is more easily absorbed by the body and does not require dietary restrictions like oral Rybelsus or Wegovy.

In an August note, Goldman Sachs analysts projected that the pill would account for a 24% share — or about $22 billion — of the global weight-loss drug market in 2030, which they expect to be worth a total of $95 billion.

They said they expect Eli Lilly pills to have a 60% share — or roughly $13.6 billion — of the daily oral segment of the market in 2030. They expect Novo Nordisk’s oral semaglutide to have a 21% share — or roughly $4 billion — of that segment.