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

“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.