The Business Press – June 26, 2023 at 10:21PM
As the world continues to grapple with the problem of obesity, pharmaceutical companies have come up with a range of drugs that can help people lose weight and keep it off in an effective way. Novo Nordisk’s Ozempic, Wegovy, and Rybelsus have dominated the market in the past year, but Eli Lilly has its own pipeline of obesity medications that promise to give doctors and patients a wider range of choices for treating the chronic condition. Eli Lilly recently presented results from studies of three of its weight loss drugs: tirzepatide (Mounjaro), orforglipron, and retatrutide, at the annual meeting of the American Diabetes Association. Tirzepatide, an injectable drug, targets two obesity-related hormones, glucagon-like peptide 1, or GLP-1, and glucose-dependent insulinotropic polypeptide, or GIP; orforglipron targets just GLP-1 but is a tablet so people can take it by mouth; and retatrutide, also an injectable therapy, targets three hormones, GLP-1, GIP, and glucagon.
GLP-1-based drugs such as these were originally developed to treat type 2 diabetes but were later found to contribute significantly to weight loss. These drugs can slow the emptying of the stomach contents, contributing to satiety, as well as regulate appetite by signaling the brain that the body has consumed enough calories, and ultimately help with weight loss.
Mounjaro is already approved by the FDA to treat type 2 diabetes since May 2022. Lilly presented data from a study that showed people taking the drug lost weight, and it is now being studied as a weight loss treatment in other trials. The study found that Mounjaro can contribute to up to 15.7% weight reduction among diabetes patients, far more than previous anti-obesity therapies have produced. However, Mounjaro requires a weekly self-injection, making it impractical for some patients. This is why Lilly, along with other pharma companies, are now exploring oral forms such as orforglipron, of these powerful weight loss drugs. Currently, there are only two drugs in this class approved to treat obesity, semaglutide (Wegovy), and liraglutide (Saxenda) made by Novo Nordisk, and both are injectable drugs. The only oral GLP1-based drug, Rybelsus, is approved for treating type 2 diabetes and can also be prescribed off-label for obesity treatment. By having approval specifically for weight loss, doctors can dispense the drugs with more confidence, based on studies that clarify which doses are most effective for shedding pounds.
Lilly presented data from its trial showing that its daily tablet orforglipron produces weight loss at levels similar to that of the injectable GLP1 drugs currently approved for obesity. The study involved more than 270 people with a body mass index (BMI) of 30 or greater, or a BMI of 27 or greater plus other risk factors associated with being overweight, such as high blood pressure, high cholesterol, heart disease, or sleep apnea. The volunteers were randomly assigned to take either an orforglipron tablet in one of four different doses once a day for nine months, or a placebo. At the end of the study, those taking orforglipron lost 9% to 14% of their starting body weight, compared to 2% among those assigned placebo. The weight loss in the orforglipron group was similar to that achieved among people taking Saxenda and those taking Wegovy.
Lilly is planning to investigate in its next trial, the specific doses of orforglipron that will balance the maximum amount of weight loss with the minimum amount of side effects such as nausea and gastrointestinal issues that the drug can cause. In another study, the company plans to present early stage results from a study of another weight loss candidate, retatrutide, a once-weekly injectable drug that targets three different obesity-related hormones. With more options for doctors and patients to choose from in coming years, obesity treatment can become more personalized, and doctors can get better at matching patients to the medications that will work best for them. Overall, with more drug-based therapies that can lead to greater amounts of weight loss, including options that achieve results comparable to surgery, more people for whom surgery was out of reach financially may be able to take advantage of a pharmacological weight loss regimen that could ultimately slow the growing epidemic of obesity.
The Business Press 