Chinese company Ascletis enters the race for anti-obesity drug

The Danish group is working on several experimental weight loss drugs, including a pill, a new generation of injections called amycretin, and another treatment called CagriSema. Amycretin showed a weight reduction of up to 14.5% at 36 weeks in patients with type 2 diabetes in a mid-phase study. Novo said the drug appeared safe and well tolerated, with mostly mild to moderate gastrointestinal side effects. Late phase studies are planned for 2026. Amycretin acts on two hormones: GLP-1 and amylin. A daily oral version of amycretin led to a weight loss of 13.1% over 12 weeks in a preliminary trial. The injectable version showed a 22% weight loss at 36 weeks in an early-mid stage study. In contrast, CagriSema, presented as a potential successor to Wegovy, disappointed in two late-stage studies: in one of the trials patients reduced weight by 22.7%, below Novo's expectations (25%). The company plans to submit CagriSema to regulatory authorities in the first quarter of 2026. Novo has also signed licensing agreements for early-stage candidates, including a deal of up to $2 billion with China's United Laboratories for a 'triple-G' candidate acting on three hormones.

For its part, Eli Lilly is now conducting late-stage studies for its once-a-week amylin-based experimental drug eloralintide in December, following the results of the last intermediate-stage study that showed a weight reduction in patients of up to 20.1%. In August, the company reported that the experimental pill orforglipron allowed patients with type 2 diabetes to lose 10.5% of weight at the highest dose (36 mg) over 72 weeks in a late-stage study. Another late-stage study, conducted this year, showed a loss of almost 8% in 40 weeks in diabetic patients. Better results compared to Novo: diabetic patients treated with the highest dose of Ozempic lost around 6%. Lilly now plans to file for regulatory approval of orforglipron by the end of the year.

The US group also signed a partnership with the Chinese biotech Laekna to develop a treatment to help patients lose weight while preserving muscle mass. And in August, it signed a deal worth up to $1.3 billion with Superluminal Medicines to develop small molecules against obesity and cardiometabolic diseases using AI.

The sector, however, is appealing to many and competition sees other pharmaceutical groups trying to enter the market and big pharma, which have fallen behind in research are trying to make up for lost time through acquisition or distribution agreements with start-ups and scale-ups, which have drugs at an advanced stage of testing.

In October Pfizer, which had had to suspend two of its own drug trials due to liver safety concerns, announced the acquisition of US company Metsera for around $7.3 billion, including future payments linked to performance targets. Metsera brings a pipeline of experimental weight loss drugs, including MET-097i, an injectable GLP-1 and MET-233i, which mimics the peptide hormone amylin. The latter is being tested as a stand-alone monthly therapy and in combination with MET-097i. In September, MET-097i showed an average weight loss of 14.1% after 28 weeks in two mid-stage studies, and Metsera aims to start late-stage studies by year-end and develop the drug in combination and oral formulations. According to Pfizer, MET-233i's initial data show a 'potentially best-in-class profile'. Analysts estimate peak sales of more than $5 billion for these candidates.

In September, Roche announced the initiation of late phase studies for CT-388, acquired through the $2.7 billion purchase of Carmot Therapeutics (2024). The drug is a weekly administration belonging to the same class as Lilly's Zepbound. Even earlier in March, Roche had acquired the rights to Zealand Pharma's obesity drug petrelintide, in a potentially $5.3 billion deal. The deal calls for an initial payment of $1.65 billion, with further compensation tied to the achievement of specific clinical and commercial milestones. The two companies will collaborate in the development of petrelintide both as monotherapy and in combination with CT-388, a GLP-1 and GIP receptor agonist developed by Roche. Marketing of the drug will be handled jointly in the US and Europe, while Roche will have exclusive rights in the rest of the world.

Last year, Amgen's experimental drug MariTide enabled overweight patients to lose up to 20% of their weight in a year-long mid-stage study.

Late phase studies will start before mid-year. Analysts consider the efficacy of MariTide to be in line with Wegovy and Zepbound, but with a slightly higher side-effect profile.

Merck later entered the slimming drug race, acquiring rights to up to USD 2 billion on the oral drug HS-10535 developed by China's Hansoh Pharma, a GLP-1 agonist similar to Wegovy and Zepbound.

The anti-obesity pill AZD5004, licensed a year ago by China's Eccogene to Astrazeneca for a deal of up to 2 billion, was shown to be safe and tolerable in an early-stage study in November 2024. The European group has already started mid-stage studies.

In August, Viking reported that its oral drug VK2735 resulted in an average loss of 12.2% over 13 weeks in a mid-stage study of 280 overweight adults, slightly below analysts' expectations (15%).

In June, Scholar Rock reported that its drug apitegromab, combined with Lilly's Zepbound, allowed patients to preserve much more lean mass: loss of 3.4 pounds after 24 weeks, compared to 7.6 pounds with tirzepatide alone.

Structure Therapeutics reported on Monday 8 December that its investigational oral pill aleniglipron reduced weight by 11.3% at 36 weeks at a dose of 120 mg in a mid-stage study. Another mid-stage study on higher doses showed a drop of up to 15.3% at 36 weeks. The company plans to start late-stage studies by mid-2026, after a meeting with the FDA scheduled for the first half of next year.