AstraZeneca joins the weight loss drug race: oral medication reduces weight by 11.8%

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AstraZeneca Enters the Oral Obesity Drug Market: Its Investigational Drug Elecoglipron Shows Mid-stage Trial Data Indicating 11.8% Weight Loss. Although the weight loss is less than Eli Lilly’s, AstraZeneca positions itself as a strong competitor in this rapidly growing market thanks to a lower dropout rate due to side effects and potential for combination with existing drugs.

The above data were released Monday at the American Diabetes Association annual meeting in New Orleans and simultaneously published in The Lancet. AstraZeneca licensed Elecoglipron from China’s Chia Tai Tianqing. In the 36-week trial, the drug achieved 11.8% weight loss, lower than the 14.7% recorded by Eli Lilly’s oral Foundayo in its mid-stage trial, while Novo Nordisk’s oral Wegovy has already demonstrated superiority to Lilly in late-stage studies.

AstraZeneca stated that Elecoglipron has entered phase 3 clinical trials and is currently being studied in combination with the kidney and heart failure drug Farxiga. The company believes that, combined with its advantage in cardiometabolic therapeutics, this drug is capable of directly competing with Eli Lilly and Novo Nordisk in the weight loss market.

Significantly Lower Side Effect Dropout Rate vs Lilly

In terms of safety, Elecoglipron shows a clear advantage. In the trial, only 5% of patients discontinued due to side effects, compared to 17% for Lilly’s Foundayo. Although some patients still experienced discomforts like nausea and vomiting, the overall withdrawal rate (including reasons unrelated to adverse events) was 24% for Elecoglipron and 28% for placebo. Notably, Lilly later reduced dropout rates in late-stage studies by adjusting dosage to improve side effects.

In addition, Elecoglipron does not require fasting before taking, whereas Novo Nordisk’s oral Wegovy does. Independent data analysis among type 2 diabetes patients also showed that the drug’s blood sugar lowering effect was comparable to Foundayo in mid-stage trials.

Sharon Barr, head of AstraZeneca BioPharmaceuticals R&D, said that Elecoglipron’s data are “highly competitive.” The company will leverage its expertise in cardiovascular and metabolic diseases to develop single-agent or fixed-dose combination therapies to address patients with comorbidities. Chief Financial Officer Aradhana Sarin told Bloomberg Radio this month, “Our real strategic differentiator is in combination therapies.”

Besides Farxiga, the company is considering developing Elecoglipron in combination with its cholesterol drug under development and the approved hypertension drug Baxfendy. Biopharmaceuticals President Ruud Dobber stated at a press event, “This is a very large and continuously growing market, and currently the proportion of treated patients is less than 5%.”

AstraZeneca also said it would further expand market coverage with competitive pricing strategies and its sales experience in emerging markets.

Phase 3 Data Pending, Pipeline Continues to Expand

External experts remain cautious about the current data. Marie Spreckley, Program Manager at the University of Cambridge’s Diabetes and Metabolic Disease Prevention Programme, said, “Larger and longer phase 3 trials are still needed to confirm the persistence of these effects, establish long-term safety and tolerability data, and determine the place of this drug in the growing spectrum of obesity and diabetes therapies.”

Looking further ahead, AstraZeneca is developing a long-acting amylin-based drug that is expected to reduce dosing frequency and decrease muscle loss. Mid-stage data are expected later this year.

It’s worth noting that high dropout rates are becoming a common challenge in obesity clinical trials. In placebo groups, patients can often quickly determine they did not receive the active drug, and as existing weight-loss drugs become widely available, participants’ willingness to remain in low-efficacy trials is also diminishing, complicating trial design and data interpretation.

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