Eli Lilly obesity pill maintains weight loss after Wegovy, Zepbound 

Eli Lilly Closely monitored obesity pill helps patients, researchers say Thursday they maintain most of the weight loss directly after you stop taking the company’s Zepbound injection, and Novo NordiskHe shot his rival Wegovy final stage trial.

The company also stated that it has applied to the Food and Drug Administration for approval of a daily GLP-1 pill called orforglipron, used against obesity. In November, the FDA said it had granted the pill a priority review voucher, which could speed up the review timeline by up to several months.

Positive trial data suggests the pill may be an effective treatment that patients can switch to if they want to maintain weight loss but don’t want to take weekly injections long-term. Many people who stop these shots regain most of the weight they initially lost.

While Eli Lilly’s pill appears to cause less weight loss overall than existing injections, Thursday’s results highlight its potential role as a needle-free maintenance treatment in the blockbuster GLP-1 market. However, Novo Nordisk’s oral anti-obesity pill will likely be the first to enter the market, giving the Danish drugmaker an advantage in making its case in this field.

The phase three trial followed more than 300 patients with obesity who had previously received Wegovy or Zepbound for 72 weeks in a separate late-stage study. These people were then randomly selected to receive either Eli Lilly pills or a placebo for an additional 52 weeks. The oral medication met the study’s main objective of showing superior weight loss compared to placebo among people who had previously experienced a stall in their progress while receiving the injection.

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

“Obesity is a chronic, progressive disease, and maintaining weight loss remains a significant challenge for many people,” Lilly President of Cardiometabolic Health Kenneth Custer said in a statement.

He said the trial showed the pill “helps people maintain the weight they’ve worked hard to lose” and, if approved, “could provide millions of individuals living with obesity worldwide with a viable alternative to continue their long-term health journey.”

Although people in the Zepbound group appeared to gain more weight, there is likely to be more focus on those switching from the drug’s biggest rival, Wegovy.

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

“Eliminating the potential of Novo’s flagship product,” Seigerman wrote.

The pill’s overall safety and tolerability (or how well patients handle the treatment) was consistent with previous late-stage studies. The most common side effects are related to the gastrointestinal tract and are generally mild to moderate in severity.

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

According to Eli Lilly, no liver safety issues were observed. 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 similarly to Wegovy, Ozempic and Novo Nordisk’s diabetes pill Rybelsus, targeting a gut hormone called GLP-1 that suppresses a person’s appetite and regulates blood sugar. Novo Nordisk also wants Wegovy’s oral version for obesity to be approved by the end of the year.

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

In an August note, Goldman Sachs analysts predicted pills would capture 24% (or about $22 billion) of the 2030 global weight-loss drug market, and they expect that market to be worth $95 billion overall.

They said they expect Eli Lilly’s pill to have a 60% share (or roughly $13.6 billion) in the daily oral segment of the market by 2030. They expect Novo Nordisk’s oral semaglutide to have a 21% share in this segment, or about $4 billion.