Summary: An experimental oral GLP-1 medication appears very effective at controlling diabetes and treating obesity.
Eli Lilly announced the results of a Phase 3 clinical trial of a once-daily GLP-1 medication, orforglipron, last month. This trial was in people with diabetes, and Lilly reported on the impact of this medication on both diabetes and obesity. Eli Lilly is the maker of the GLP-1 medications called Zepbound (for obesity) and Mounjaro (for diabetes).
The average HbA1C decrease at 40 weeks was 1.3 - 1.6%, depending on the dose, compared to 0.4% for those on placebo. This demonstrates that the drug is very effective at controlling diabetes. The most commonly reported adverse events were gastrointestinal-related and generally mild to moderate in severity.
Weight loss was 4.7 - 7.9% during the same time period, again based on dose of medication, compared to 1.7% weight loss for those on placebo. Interestingly, an earlier Phase 2 trial for orforglipron result had higher weight loss, up to 14.7% average loss of body weight after 36 weeks, compared to 2.3% in the placebo group.
A potential advantage of orforglipron is that, unlike oral semaglutide (Rybelsus), it need not be given on an empty stomach. Oral medications are easier to manufacture and distribute than injections that require refrigeration and filling of pens. Eli Lilly states that it is planning to release further data on orforglipron later this year in both diabetic and obese groups. Lilly will likely seek FDA approval for orforglipron to treat both diabetes and obesity.
Oral versions of GLP-1s appear to have good efficacy and safety and will be available in the next 1-2 years to treat diabetes and potentially obesity.
The oral versions will increase access and availability, likely putting upward pressure on overall GLP-1 costs for employers that cover this drug class for obesity.
Hopefully, additional drugs from different manufacturers will lead to lower prices for GLP-1s.
