Pharmaceutical companies Eli Lilly and Novo Nordisk have released new clinical trial data on experimental obesity and Type 2 diabetes treatments that target the hormone amylin. The companies are developing these drugs as both standalone therapies and in combination with existing GLP-1 agonist medications to create additional options for weight management.
Eli Lilly announced results from a Phase 2 trial of its experimental drug, eloralintide, an amylin-targeting therapy. When combined with tirzepatide, the active ingredient in its drugs Zepbound and Mounjaro, patients with obesity and Type 2 diabetes experienced greater weight loss than with tirzepatide alone.
According to an efficacy analysis released by the company, participants receiving the highest-dose combination lost an average of 23.3% of their body weight over 48 weeks. This compared to an average weight loss of 14.8% for those taking only a high dose of tirzepatide.
The company also reported that a higher percentage of patients on the combination therapy discontinued treatment due to side effects. Depending on the dosage, 10.8% to 27% of participants on the combination regimen stopped treatment, compared to 2.9% of those on tirzepatide alone.
“These are encouraging results,” said Benjamin Bikman, a professor at Brigham Young University who researches metabolic health, noting that adults with Type 2 diabetes often lose less weight on such therapies. Dr. Caroline Apovian, co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital, commented on the discontinuation figures, stating, “27% is not a good number.”
Eli Lilly plans to begin Phase 3 trials for the combination therapy later this year.
Novo Nordisk is also developing treatments targeting the amylin pathway. The Danish company’s drug, cagrilintide, is being tested as a standalone treatment and in combination with semaglutide, the active ingredient in Ozempic and Wegovy. The combination therapy is known as CagriSema.
In a recent functional magnetic resonance imaging (fMRI) study, Novo Nordisk reported that CagriSema reduced persistent thoughts about food, referred to as “food noise,” in individuals who were overweight or had obesity. The study measured brain activity and, according to the company, showed changes in brain regions associated with cravings and self-control.
“The signal in the brain changes in a way that actually is associated with improved quality of life,” Martin Holst Lange, Novo Nordisk’s chief scientific officer, said in an interview about the findings.
Amylin is a hormone released in the pancreas along with insulin that helps regulate appetite and slow the rate at which food moves through the stomach. This mechanism is similar to that of GLP-1 hormones but operates through a different biological pathway. “It’s the same outcome, but a different approach,” Bikman said.
The development of amylin-based therapies reflects a broader industry focus on treatments that target multiple hormone pathways. Tirzepatide, for example, combines a GLP-1 agonist with a GIP agonist. Another experimental drug from Eli Lilly, retatrutide, targets GLP-1, GIP, and glucagon receptors.
Leerink Partners analyst David Risinger told CNBC that amylin-based drugs could “offer a major new treatment alternative for patients.” He forecast that Eli Lilly’s eloralintide products could generate $23.2 billion in annual sales by 2035.
Both companies’ experimental treatments must undergo further large-scale clinical trials and receive regulatory approval before they can be made available to the public.
