Obesity drugs gain weight in labs: Several clinical trials by big and small pharma cos underway

Mumbai: As blockbuster weight-loss drugs Wegovy (semaglutide) and Mounjaro (tirzepatide) reap billions of dollars on hysteric demand for innovators Novo Nordisk and Eli Lilly, more pharma companies — big and small — are racing to join the frenzy.

As many as 170 new anti-obesity drugs are in various stages of development — from preclinical evaluation to advanced trials — though medical experts advise caution against their harmful effects due to reckless self-medication. Data collated from the obesity drugs tracker of Stat News, a popular Boston-based website on medical and healthcare analytical and investigative news, show Amgen, AstraZeneca, Boehringer Ingelheim, Roche and Regeneron are among the big names that are part of the choking pipeline.

However, giants like Swiss drug maker Novartis and UK-based GSK are taking a cautious view of the opportunity.

Pfizer had a setback recently with its experimental pill danuglipron that resulted in liver injury in a patient during the clinical trials. Eli Lilly, which is seeing record-shattering sales, with its Zepbound/Mounjaro brands, has at least nine drugs listed in active research.



Its Danish rival Novo Nordisk is working on 14 leads, including additional studies on the already approved products.

In a mailed response to ET, an Eli Lilly India spokesperson said the company invests approximately 25% of its revenue in R&D, significantly exceeding industry benchmarks. “We are strategically focusing on areas of high unmet need, such as obesity, a chronic disease that requires more effective treatment options. Our goal is to modernise how this disease is approached, and we are making bold, science-driven decisions to explore new treatment modalities,” she said.



Referring to orforglipron, its nonpeptide, oral GLP-1 receptor agonist being studied for the treatment of obesity and type-2 diabetes, the Lilly spokesperson said, “We’ve seen so far, we have a high degree of confidence on what this molecule could mean for patients.” But several drugs on the Stat News tracker are once-a-week injectables with the sole exception of San Diego-based Skye Bioscience, which is developing a once a-month injectable drug. Interestingly, like orforglipron, at least 64 drugs being developed are in the oral or pill form, marking a shift that will make dosing compliance easier and result in lower manufacturing costs than the injectables.

A growing number of Chinese companies including Innovent, Sciwind, Zhejiang Doer, Innogen and Jiangsu Hengrui are catching up with their western counterparts on the back of speedy trials and conducive regulatory pathways, while India’s Sun Pharma is the only one from the country that is listed to develop its own molecule utreglutide in earlystages of clinical trials.

The other big names from India such as Dr Reddy’s, Biocon, Cipla and Torrent are developing copies of semaglutide, which is pending patent expiry early next year.

FRONTLINE STRATEGY AGAINST NCDS
Diabetologist and obesity expert Rajiv Kovil told ET that the emergence of powerful anti-obesity therapies is driving a fundamental shift in the treatment of non-communicable diseases (NCDs). Now, he says, obesity care is no longer an afterthought, it’s becoming the frontline strategy against NCDs.

Stat News data show the areas of research for obesity drugs is rapidly expanding beyond targeting the GLP-1 gut hormones. Currently multiple modalities are being approached like silencing certain genes using the RNA interference technology that may have a longer effect than the injectables. Another biologic pathway is to target amylin, a hormone secreted by pancreas and has a role in stomach emptying and reduced calorie intake, without causing nausea or muscle loss.

Some of the research involves combining multiple targets like GLP-1/GIP and amylin analogues.

The competitive landscape is expected to change as at least 10 drugs are in phase-III clinical trials, the stage before which regulatory agencies grant marketing approvals. Besides the benefits in weight loss, the new experiments on an array of conditions are underway. Those include MASH (metabolic dysfunction-associated steatohepatitis), cardiovascular disease (CVD), obstructive sleep apnea, neurological disorders like Alzheimer’s disease, polycystic ovary syndrome (PCOS), chronic kidney disease (CKD), heart failures and arthritis.