The Biggest Losers: Obesity Therapeutics Landscape
GLP-1 has transformed the therapeutic landscape, with Novo’s Semaglutide and Lilly’s Tirzepatide becoming amongst the highest revenue generating drugs on the market today. Novo Nordisk has lost its first mover advantage to Eli Lilly, with analysts predicting that by 2030 Lilly will have 47% of a $90bn market, to Novo’s 40%. Here, we present our report “The biggest losers: the obesity therapeutics landscape” analyzing clinical pipeline of next-generation injectables, oral GLP-1 therapeutics, as well as mapping of 82 biotechs developing the next wave of obesity drugs.
Highlights:
● Roche passed on the chance to run oral GLP-1 RA Orforglipron, which was picked up by Eli Lilly for $50M. Analysts now predict the molecule to reach $25B peak annual sales.
● Lilly’s Retatutride outperforms Novo’s Cagrisema in terms of maximal body weight reduction (-24.2% vs -20.4% in the highest dose groups), making it the highest weight loss potential therapeutics.
● The maintenance of lean mass during weight loss has become a focus, with companies like Keros Therapeutics attempting to compete with Lilly’s Bimagrumab to inhibit the Activin/Myostatin pathway.
● Oligonucleotides are an emerging modality, with companies like Alnylam and Arrowhead competing to knockdown genetically validated targets in liver and adipose tissue as a supplement to GLP-1 RAs.
● High discontinuation rates and the weight rebound effect are motivating the development of gene therapies to address the chronic nature of obesity, spearheaded by companies like Fractyl health.
● Creative approaches pursued by biotechs include selective amino acid starvation, oral peptides to induce native GLP-1 secretion, and controlled mitochondrial uncoupling to increase energy expenditure.
