Lilly's weight loss drug, Forglipron, achieves key milestone in Phase III clinical trials

British biotech firm Verdiva Bio Ltd may face similar challenges as it progresses its oral amylin and GLP-1 RA candidates through development, joining a crowded field of competitors. The market for GLP-1-based weight loss therapies is projected to reach $150bn by 2030, making it a lucrative but competitive space.

Eli Lilly's GLP-1 receptor agonist, orforglipron, has shown promising results in clinical trials. In a study involving individuals with diabetes and obesity, orforglipron achieved an average weight reduction of 11% after 72 weeks of treatment at a daily dose of 36 mg. However, the trial results failed to impress Wall Street analysts, leading to significant revisions in revenue forecasts for Lilly.

Novo Nordisk, another major player in the field, expects FDA approval for its oral version of semaglutide in Q4 2025, giving it a lead of four months. In Novo Nordisk's Phase III registration trial for oral semaglutide, there was a median weight loss of 15% in obesity patients, compared with a 2.2% reduction in the placebo group. The comparatively lower incidence of side effects with oral semaglutide may offer a short-term advantage.

In Phase II trials, VK2735, a dual GLP-1/GIP RA, achieved a 12.2% reduction in body weight compared with placebo after 13 weeks of treatment. Among the subgroup of patients with both type 2 diabetes and obesity in Novo Nordisk's trial, the median weight loss was 10.5%.

Gasherbrum Bio and Structure Therapeutics are developing the oral non-peptidic GLP-1 receptor agonist GSBR-1290 (Aleniglipron). Results from a Phase IIb trial are expected in Q4 2025. Merck/Hansoh Pharma's HS-10535, AstraZeneca and ECC5004 from Eccogene, Roche's CT-966, and Verdiva Bio Ltd's oral amylin and GLP-1 RA candidates all face issues with bioavailability.

Weekly injections may remain the more favourable option until oral formulations are further optimised. Novo Nordisk recently entered into a partnership to further optimise the bioavailability and tolerability of its oral formulation.

The increasing competition in the market for GLP-1-based weight loss therapies has led to a decrease in the market capitalisation of both Eli Lilly and Novo Nordisk. Lilly's current market capitalisation is US$729.58bn, a 17% decrease from its peak, while Novo Nordisk's current market capitalisation is US$308.04bn, a 66% decrease from 2023. The new CEO of Novo Nordisk is facing uncertainty about the company's ability to recover from its recent crisis and market valuation drop.

In conclusion, the race to develop effective and well-tolerated oral GLP-1-based weight loss therapies is heating up, with several major pharmaceutical companies vying for a share of the projected $150bn market by 2030. However, challenges remain with regard to bioavailability, and the more favourable option may still be weekly injections until oral formulations are further optimised.

Lilly's weight loss drug, Forglipron, achieves key milestone in Phase III clinical trials