Eli Lilly's once daily oral pill shows major weight loss in trials: Is this easier to use than taking a shot?

Indian Express

4 days ago

Weight loss with pharmaceutical giant Eli Lilly's once-daily oral pill, orforglipron, was found to be similar to the oral and injectable version of its competition semaglutide but inferior to its own injectable weight loss drug tirzepatide. Those on the highest 36 mg dose of the medicine on average lost 12.4 per cent of their body weight at 72 weeks, according to the initial results announced by the company on Thursday.
There are no head-to-head trials comparing orforglipron and oral semaglutide. However, a previous trial to assess the effectiveness of semaglutide published in 2023 showed that participants on the highest 50 mg dose on average lost 15.1 per cent of their body weight in 68 weeks.
'The weight-loss is not as dramatic as seen with tirzepatide. The benefit, however, is that it is an oral medication. When it comes to the market — it is likely to compete with the oral version of semaglutide,' said Dr Anoop Misra, chairman, Endocrinology and Diabetes, Fortis C-DOC centre. 'Some people would like to switch to the medicine if it is cheaper — given that it is easier to use instead of the weekly shots,' he adds
What is orforglipron?
It is a GLP-1 drug, which mimics the hormone GLP1 in regulating blood sugar in users.
Lilly's injected drug, tirzepatide, sold as Mounjaro, mimics GLP1 as well as GIP, which regulates lipid metabolism.
Collectively, they are called incretin mimetics, which mimic the action of certain gut hormones to improve secretion of insulin, inhibit secretion of glucagon that stimulates glucose production in the liver and reduce appetite by slowing down digestion.
What do the recent findings announced by the company show?
The findings are based on the ATTAIN-1 trial that had 3,127 participants who were obese or overweight, not diabetic, but had other co-morbidities such as hypertension, dyslipidemia, obstructive sleep apnoea, or cardiovascular disease. The participants were from across the US, Brazil, China, India, Japan, South Korea, Puerto Rico, Slovakia, Spain and Taiwan.
The study found that the participants on average lost 7.8 per cent of their body weight with the lowest 6 mg dose, 9.3 per cent with the 12 mg dose, and 12.4 per cent with the highest 36 mg dose. The study also showed that nearly 60 per cent of all the participants on the highest dose of the medicine lost at least 10 per cent of body weight. Around 40 per cent of the people on the same dose lost more than 15 per cent of their body weight, which is almost comparable to the kind of weight-loss seen with bariatric surgeries.
How does it compare to other weight-loss medicines in the same class?
The weight loss achieved by the oral medicine is similar to the impacts seen with both oral and injectable semaglutide. However, it is lower than the company's own once-weekly injectable drug tirzepatide, which has demonstrated as much as 26 per cent weight loss over a period of 84 weeks.
Why is this important?
Given its ease of use compared to weekly shots, an oral regimen is likely to make the drugs more accessible.
Another important distinction, which may make orforglipron the preferred pill, is that it is the first small molecule GLP-1 drug. To compare, the oral semaglutide is a peptide molecule or a chain of amino acids that are inserted through a delivery system that prevents it from degradation in the stomach. Small molecule drugs are generally easier and cheaper to manufacture than peptides that have a more complex structure.
Anonna Dutt is a Principal Correspondent who writes primarily on health at the Indian Express. She reports on myriad topics ranging from the growing burden of non-communicable diseases such as diabetes and hypertension to the problems with pervasive infectious conditions. She reported on the government's management of the Covid-19 pandemic and closely followed the vaccination programme.
Her stories have resulted in the city government investing in high-end tests for the poor and acknowledging errors in their official reports.
Dutt also takes a keen interest in the country's space programme and has written on key missions like Chandrayaan 2 and 3, Aditya L1, and Gaganyaan.
She was among the first batch of eleven media fellows with RBM Partnership to End Malaria. She was also selected to participate in the short-term programme on early childhood reporting at Columbia University's Dart Centre. Dutt has a Bachelor's Degree from the Symbiosis Institute of Media and Communication, Pune and a PG Diploma from the Asian College of Journalism, Chennai. She started her reporting career with the Hindustan Times.
When not at work, she tries to appease the Duolingo owl with her French skills and sometimes takes to the dance floor. ... Read More