Eli Lilly and Novo Nordisk Race to Develop Next-Generation Obesity Drugs Targeting Amylin
TREE NEWS reports: Eli Lilly and Novo Nordisk are intensifying their competition in the obesity treatment market, with both pharmaceutical giants now focusing on amylin-based therapies as the next frontier beyond GLP-1 drugs. Eli Lilly this week released Phase 2 clinical data showing its experimental amylin drug eloralintide, when combined with tirzepatide, achieved an average weight loss of 23.3% over 48 weeks in the highest-dose group, significantly surpassing the 14.8% weight loss seen with tirzepatide alone. This development signals a strategic shift toward combination therapies that stack multiple hormonal mechanisms to push weight loss efficacy higher.
Clinical Data and Market Implications
The Phase 2 trial targeted patients with obesity and type 2 diabetes, a population that typically experiences less weight loss with existing therapies. The combination approach aims not to replace GLP-1 drugs but to offer an alternative for patients who do not achieve sufficient results or cannot tolerate current treatments. Analysts at Leerink Partners project that Eli Lilly’s eloralintide product line could generate annual sales of $23.2 billion by 2035, with standalone therapy expected to launch in 2029 and the combination in 2030. The potential market is substantial: more than 10 million people may have tried GLP-1 drugs without success due to efficacy, tolerability, or genetic factors.
However, tolerability remains a critical challenge. In the combination therapy groups, discontinuation rates due to side effects ranged from 10.8% to 27%, compared to just 2.9% for tirzepatide alone. Dr. Caroline Apovian of Brigham and Women’s Hospital noted that “27% is not a good number,” emphasizing that Phase 3 trials will need to demonstrate both efficacy and tolerability. Eli Lilly plans to initiate Phase 3 trials later this year.
Novo Nordisk’s Parallel Strategy
Novo Nordisk has been developing amylin-based therapies for years. Its drug cagrilintide, when combined with semaglutide as CagriSema, has shown greater weight loss in clinical studies. CagriSema is expected to launch early next year, with standalone cagrilintide and high-dose CagriSema anticipated in 2028. New data released this week from a one-year brain imaging study showed that CagriSema not only reduces weight but also decreases “food noise”—persistent thoughts about food—and improves organ and bone health. The drug altered brain responses to high-calorie foods in regions associated with craving, pleasure, and self-control.
Novo Nordisk is also developing amycretin (zenagamtide), a single molecule that mimics both GLP-1 and amylin, tested as a weekly injection and daily oral tablet. Positive Phase 2 results were reported earlier this year. The company’s multi-target approach reflects a broader industry trend: moving from dual to triple agonists. Eli Lilly’s retatrutide targets GLP-1, GIP, and glucagon, reporting the largest weight loss to date. Pfizer, AstraZeneca, and Viking Therapeutics are also developing amylin products.
Investor Takeaways
- Growth potential in obesity market: The global obesity drug market is projected to exceed $100 billion by 2030. Companies with successful amylin-based therapies could capture significant share, especially for patients unresponsive to GLP-1 drugs.
- Tolerability is key: High discontinuation rates in combination therapies could limit adoption. Investors should monitor Phase 3 data for safety and tolerability profiles.
- Competitive landscape: Eli Lilly and Novo Nordisk are well-positioned, but emerging players like Pfizer and AstraZeneca could disrupt the market. Partnerships and licensing deals may accelerate development.
- Broader impact: Successful obesity treatments could reduce healthcare costs associated with diabetes and cardiovascular diseases, benefiting insurers and healthcare systems.
As the race intensifies, the next 12-18 months will be crucial for regulatory approvals and market launches. Investors should watch for Phase 3 trial results, regulatory submissions, and commercialization strategies from both companies.
