GLP-1 Healthspan Proxies

Eli Lilly and Company presented new efficacy data from studies of its marketed and investigational metabolic medicines at the annual European Association for the Study of Diabetes conference. In the phase III ACHIEVE-4 study, Foundayo (orforglipron), a once-daily oral GLP-1 receptor agonist approved for chronic weight management, demonstrated a non-inferior risk of major adverse cardiovascular events versus titrated insulin glargine, with MACE-4 risk 16% lower, MACE-3 risk 23% lower, cardiovascular death risk 53% lower and all-cause death risk 57% lower; at 52 weeks A1C declined 1.6% versus 1% and body weight fell 8.8% versus a 1.7% increase, while 10.6% discontinued due to adverse events. Lilly also reported positive 48-week results from a phase IIb study of EloraTZP, an investigational combination of eloralintide and Zepbound, in adults with obesity or overweight and type II diabetes, where the highest-dose combination of 9 mg eloralintide plus 15 mg Zepbound reduced body weight by 23.3% (54.1 pounds) versus 14.8% (34.4 pounds) for Zepbound 15 mg alone, and A1C declined 2.9% versus 2.4%. Separately, the phase IIIb ADtouch study of Ebglyss (lebrikizumab-lbkz) met its primary and secondary endpoints, with 53% of patients on monotherapy achieving clear or almost clear hands and feet at week 16 versus 27% with placebo, and Lilly has submitted the data to the FDA seeking a potential U.S. label expansion to include localized atopic dermatitis with moderate-to-severe hand and foot involvement. Lilly has also submitted a regulatory filing to the FDA seeking approval of Foundayo for the treatment of type II diabetes, with the application currently under review, intensifying its oral GLP-1 competition with Novo Nordisk's oral Wegovy, Ozempic and Rybelsus.

Regeneron Pharmaceuticals announced new Phase 2 COURAGE trial results showing that trevogrumab prevented 70% of the muscle loss associated with semaglutide treatment in people living with obesity. In a predefined MRI substudy, lower-dose trevogrumab preserved almost 70% of the thigh muscle that would otherwise have been lost with semaglutide alone, with 71.8% preservation at 52 weeks for the 25 mg dose and 68.9% for the 75 mg dose relative to placebo plus semaglutide. The lower-dose portion of the trial, which evaluated trevogrumab at 25 mg or 75 mg in combination with semaglutide 2.4 mg over 52 weeks, replicated the higher-dose findings, preserving lean mass at both 26 and 52 weeks, the primary endpoint, though it did not meaningfully enhance weight loss achieved with semaglutide alone. A pre-specified subgroup analysis found that patients meeting the low lean mass definition for sarcopenia had greater loss of lean mass with semaglutide and more preservation with trevogrumab. The results were presented at the European Association for the Study of Diabetes Annual Meeting and are in press with The Lancet, and Regeneron is planning to initiate a Phase 2 trial of trevogrumab in combination with GLP-1 receptor agonist-based therapies in older adults with obesity and decreased muscle mass and/or strength.

Novo Nordisk's oral Wegovy, or semaglutide, produced real-world weight loss in adults with overweight or obesity who switched from injectable GLP-1 therapies, according to data from the OCTANE study presented at the European Association for the Study of Diabetes on Sept. 30, 2026. The retrospective analysis, which drew on de-identified data from the Ro telehealth platform, covered 194 participants who moved from injectable Wegovy or Eli Lilly's Zepbound, or tirzepatide, to once-daily oral Wegovy between Jan. 5 and Feb. 7, 2026, and stayed on the pill for three months with weight data available at baseline and follow-up. Participants lost an average of four kilograms, or 8.8 pounds, over three months, equal to 4.1% of baseline body weight, while 40.7% achieved at least 5% weight loss and the share with a BMI of at least 30 kg/m2 fell 21.6 percentage points, from 87.1% at baseline to 65.5% at three months. Among participants with available information, 82.4% reported at least one treatment improvement, most often better-fitting clothes and healthier eating. Novo cautioned that the observational design cannot establish causality and cited limitations including variable data collection, self-reported measures, selection bias from requiring treatment persistence and limited generalizability. The Wegovy pill has launched in the United States, the United Arab Emirates, the United Kingdom and Germany, with additional select markets planned in coming quarters. Separately at the same conference, Novo presented 52-week functional MRI data showing CagriSema, its investigational once-weekly combination of cagrilintide and semaglutide, altered brain responses to high-calorie food cues and was linked to a 22.4% body-weight reduction versus placebo, along with a 14.3% weight reduction at week 40 in a diabetes MRI sub-study of the phase IIIa REIMAGINE 1 trial and a 14.2% weight reduction at week 68 in a post hoc analysis of phase III REIMAGINE 2. Novo submitted a new drug application to the FDA for CagriSema in weight management in December 2025, with a decision expected in the fourth quarter, and in 2026 began a phase III study of high-dose CagriSema 2.4 mg/7.2 mg in adults with obesity.

Novo Nordisk reported that Wegovy, its injectable semaglutide, brought liver fat down to normal levels in nearly nine out of ten adults with obesity and excess liver fat, according to a post hoc analysis of a 55-participant sub-population of the STEP UP trial presented at the European Association for the Study of Diabetes Annual Meeting 2026 in Milan. Among the 26 participants who entered with liver fat above 5%, 88.5%, or 23 people, reached the below-5% threshold by week 72, while mean liver fat across the group fell from 8.8% at baseline to 3.1% at week 72 as measured by magnetic resonance imaging. The analysis pooled 1,919 adults from the STEP UP and STEP UP T2D trials, of whom 1,312 received semaglutide 7.2 mg, 304 received semaglutide 2.4 mg and 303 received placebo, and more than 94% were classified as high risk for fatty liver by the Fatty Liver Index at baseline. Eric Lawitz of the Texas Liver Institute and University of Texas Health San Antonio said the findings suggest semaglutide may help address liver disease early, noting that as many as three in four people with obesity may have excess liver fat. Novo chief medical officer Filip Knop said the results help show the quality of weight loss seen with semaglutide, adding that the dedicated ESSENCE MASH trial demonstrated reversal of liver damage in people with MASH. Semaglutide 2.4 mg is approved for the treatment of MASH under the Wegovy brand in the United States, Canada, the United Kingdom, China and several other markets, while semaglutide 7.2 mg is not being investigated for MASH.

Novo Nordisk said new real-world data from its COMPETE SWITCH Cardiovascular study found that type II diabetes patients who increased their Ozempic dose had a lower observed risk of major adverse cardiovascular events than those who switched to Eli Lilly's Mounjaro. In the study, 67.2% of patients remained on Ozempic 1 mg within 365 days, 29.2% increased their dose to 2 mg and 3.6% switched to Mounjaro; by 720 days, 57.4% remained on semaglutide 1 mg, 36.9% had escalated to 2 mg and 5.7% had switched to Mounjaro. After adjustment for between-group differences, patients who increased their dose to Ozempic 2 mg had a statistically significant 6% lower risk of MACE than those who switched to Mounjaro, including doses of up to 15 mg, with MACE defined as all-cause death, heart attack and stroke. Novo cautioned that the study showed an association, not proof, that Ozempic 2 mg directly reduces cardiovascular risk more than Mounjaro, and that safety outcomes were not evaluated. Year to date, Novo shares have lost 22.2% against the industry's 14.9% growth.

Eli Lilly reported that its experimental obesity and type 2 diabetes combination EloraTZP delivered up to 23.3% average weight loss in a Phase 2b trial, sending its shares up as much as 2.6% before closing 0.5% higher. In the 48-week trial of 367 participants, the combination of eloralintide and tirzepatide produced average weight loss of up to 54.1 lbs, or 23.3%, far outpacing the 34.4 lbs, or 14.8%, achieved by a 15 mg dose of tirzepatide alone. EloraTZP also reduced A1C levels by an average of up to 2.9%, compared with 2.4% for tirzepatide, and met all primary and secondary endpoints across the tested dose combinations, with the highest dose of 9 mg eloralintide plus 15 mg tirzepatide yielding the greatest reductions. The triple-hormone therapy activates GIP, GLP-1 and amylin; gastrointestinal side effects were the most common, and discontinuation rates for EloraTZP ranged from 10.8% to 27.0%, versus 2.9% for tirzepatide alone and 16.7% for placebo. Following the results, presented at the 62nd Annual Meeting of the European Association for the Study of Diabetes in Milan, Italy, Eli Lilly plans to begin Phase 3 trials of EloraTZP in the fourth quarter of 2026, while shares of rival Novo Nordisk slipped 0.3%.

Novo Nordisk presented new data at the European Association for the Study of Diabetes Annual Meeting 2026 showing that its investigational obesity and diabetes drug CagriSema changes brain responses to high-calorie food cues and reduces harmful fat around organs while maintaining bone health. In a 52-week functional magnetic resonance imaging study in adults with overweight or obesity, CagriSema improved eating behaviour and reduced 'food noise', cravings, hunger and appetite, and was associated with a 22.4% reduction in body weight versus placebo at 52 weeks. Separately, in a diabetes MRI sub-study of the phase 3a REIMAGINE 1 trial in adults with early type 2 diabetes, CagriSema 2.4 mg/2.4 mg produced significant reductions in fat in the abdomen and around the liver and pancreas alongside a 14.3% body-weight reduction at week 40, while a post hoc analysis of bone markers from the phase 3 REIMAGINE 2 trial showed signs of healthy bone maintenance alongside a 14.2% body-weight reduction at week 68. Novo Nordisk submitted a New Drug Application for CagriSema for weight management to the US Food and Drug Administration in December 2025, with a decision expected in Q4 2026, and initiated a phase 3 trial of high-dose CagriSema 2.4 mg/7.2 mg in adults with obesity in 2026.

Hengrui Medicine announced that it has signed a licensing agreement with Novo Nordisk for the HRS-1596 project, granting the global weight-loss drug leader Novo Nordisk rights to its independently developed HRS-1596. The potential total transaction value is up to 2.6 billion US dollars, marking another step forward for Chinese innovative drug companies in the global weight-loss sector. On the same day, Dizal Pharmaceutical announced that it recently received a 600 million US dollar upfront payment from AstraZeneca. Boosted by this news, on September 30, the medical services concept rose 3.22 percent intraday, Yiqiao Shenzhou rose 13.14 percent, Nanmo Bio rose 10.70 percent, Berry Genomics rose 10.02 percent, Biopsychus rose 8.02 percent, and PharmaBlock Sciences rose 5.61 percent. Industrial Securities believes that innovation plus globalization remains the main theme for the pharmaceutical sector throughout the year. Multinational pharmaceutical companies facing patent cliffs need external pipelines, while domestic drug companies' R&D efficiency advantages are becoming more prominent, and cooperation models are upgrading, representing an increase in China's innovative voice.

Zealand Pharma announced that results from its Phase 2 ZUPREME-1 trial of investigational petrelintide have been published in The Lancet Diabetes & Endocrinology, with additional data to be presented at EASD 2026 on September 30 at 3:30pm CEST. In the randomized, double-blind, placebo-controlled, dose-finding trial, 485 adults with a mean age of 47 years and a BMI of 36.7 kg/m² were assigned 5:1 to once-weekly subcutaneous petrelintide at 1.0 mg, 2.5 mg, 5.0 mg, 7.0 mg or 9.0 mg, or placebo, for 42 weeks including dose escalation. Petrelintide led to mean body weight reductions from baseline to week 42 of up to 10.7% versus 1.7% for placebo on the efficacy estimand, and up to 10.2% versus 1.4% on the treatment policy estimand. Gastrointestinal adverse events were generally mild and occurred at rates similar to placebo, with no cases of vomiting and no treatment discontinuations due to gastrointestinal adverse events at the maximally effective dose. Treatment was also associated with reductions in waist circumference of up to 10.8 cm versus 4.3 cm with placebo, up to 41% reductions in high-sensitivity C-reactive protein versus 6% with placebo, triglyceride reductions of up to 21% versus 9%, and a mean pulse rate reduction of up to 2.9 beats per minute versus a mean increase of 0.3 bpm with placebo. Petrelintide is being evaluated for chronic weight management in three global Phase 3 registrational trials, and a Phase 2 trial of petrelintide in combination with enicepatide is planned for initiation in the second half of 2026.

Novo Nordisk has entered an exclusive license with Hengrui Pharma for a once-weekly oral GLP-1/GIP dual agonist, adding a late-stage oral candidate to its metabolic pipeline. The deal complements Novo Nordisk's existing injectable and oral GLP-1 work and sits alongside its Nanexa long-acting injectable agreement and Orbis macrocycle partnership. Separately, Phase 3 CagriSema data delivered new weight management clinical results, with a CagriSema NDA decision expected in the fourth quarter of 2026. The CHMP issued a positive opinion backing Sogroya for idiopathic short stature and supported FREHEMGO for hemophilia A patients, with European Commission rulings on both still pending. Novo Nordisk, a pharmaceuticals group with a DKK1.1 trillion market cap, is also pursuing a MASLD and MASH collaboration with Siemens Healthineers.

Eli Lilly shares edged 1% higher in morning trading Tuesday after new data showed its oral Foundayo treatment produced greater weight and blood-sugar reductions than oral semaglutide at higher doses. The analysis examined 17.2 mg of Foundayo, or orforglipron, in adults with type 2 diabetes, and at week 52 patients receiving the Lilly drug recorded 1.5% more body-weight reduction than those taking 25 mg of oral semaglutide. The blood-sugar measure A1C also moved in Lilly's favor, with the analysis showing a further 0.3% reduction compared with the semaglutide group. The findings were presented during the European Association for the Study of Diabetes meeting in Milan, where EASD materials listed additional studies involving the treatment. Lilly has been developing Foundayo across its diabetes program as competition in oral GLP-1 medicines expands, though the comparison comes from separate studies rather than a direct head-to-head trial.