Oral Obesity Drugs Challenge Injectable Dominance in Weight Loss Market

The pharmaceutical industry is witnessing a significant shift in the obesity treatment landscape as several companies race to develop oral medications that could rival the efficacy of injectable weight loss drugs. This surge in oral obesity drug development is driven by the potential to expand market reach and improve patient compliance.

Eli Lilly's Orforglipron Leads the Oral GLP-1 Pack

Eli Lilly's orforglipron, an oral GLP-1 receptor agonist, has emerged as a frontrunner in the oral obesity drug market. In the Phase III ATTAIN-1 study, orforglipron demonstrated a 12.4% average weight reduction at 72 weeks, compared to 0.9% in placebo groups. Nearly 60% of patients on the highest dose lost 10% of their body weight.

Despite these promising results, analysts from Truist Securities and William Blair noted that the efficacy falls short of injectable alternatives, leaving room for competition. However, orforglipron's oral formulation could still give it an edge in the market, particularly among needle-phobic patients and those who prefer pills to injections.

Novel Mechanisms and Emerging Competitors

Several pharmaceutical companies are exploring alternative pathways and mechanisms to treat obesity:

1. Novo Nordisk's amycretin, an oral amylin analog, has shown promising results in early-stage trials. The drug achieved a 13.1% average weight reduction after 12 weeks in Phase I studies.

2. Viking Therapeutics' VK2735, a dual GLP-1/GIP receptor agonist, demonstrated an 8.2% average weight loss after 28 days at the highest dose in Phase I trials. The company is currently conducting a Phase II study with results expected later this year.

3. Roche's CT-996, acquired from Carmot Therapeutics, is a once-daily oral GLP-1 analog that showed a 7.3% reduction in body weight after 4 weeks in Phase Ib trials. Roche plans to initiate Phase II studies later this year.

4. Terns Pharmaceuticals' TERN-601, another oral GLP-1 receptor agonist, achieved a 4.9% placebo-adjusted weight loss over 28 days in Phase I studies. The company is currently seeking a partner for further development.

5. Rhythm Pharmaceuticals' bivamelagon, which activates the melanocortin-4 receptor (MC4R), demonstrated a 9.3% reduction in body mass index over 14 weeks in patients with acquired hypothalamic obesity during Phase II trials.

Market Implications and Future Outlook

The development of oral obesity medications has the potential to significantly expand the weight loss drug market. Oral formulations may increase accessibility, potentially lower prices, and improve patient compliance compared to injectable alternatives.

However, safety concerns remain a critical factor in the development of these drugs. Many candidates have reported gastrointestinal side effects, including nausea, vomiting, and constipation, which could impact their widespread adoption.

As the race to bring oral obesity drugs to market intensifies, the coming months will be crucial in determining which candidates have the potential to challenge the dominance of injectable weight loss medications and reshape the obesity treatment landscape.