Novo Nordisk’s oral amycretin tops Wegovy in obesity trial


Within Novo Nordisk's comprehensive business update to investors, attention latched onto early data for an oral obesity therapy that outperformed the company’s big-selling GLP-1 agonist Wegovy in a clinical trial.

The drug, called amycretin and codenamed NN9487, is a dual agonist that targets both GLP-1 and amylin and is being developed in both oral and subcutaneous injection formulations.

The oral form has completed a phase 1 study, and Novo Nordisk reported results from the first 16 patients out of a total planned enrolment of 144. After 12 weeks, weight loss with the drug was 13% of body weight, compared to 1% with placebo, which the company said was around twice the level achieved with Wegovy (semaglutide) at that time point.

The company's head of development, Martin Lange Holst, told the meeting that the promising results justify further research and a larger phase 2 trial is planned for the second half of this year, with results expected in around 2026. 

Novo Nordisk’s already buoyant share price rose even further on the update, which showed that the company has new therapies coming through that could extend and sustain the obesity franchise as new competitors like Eli Lilly, Pfizer, MSD, and Boehringer Ingelheim/Zealand Pharma start to eye a market that has been estimated to be worth $100 billion within a decade.

Data on the subcutaneous version of amycretin is due next year, and Novo Nordisk also presented early data on another oral therapy, CBR1 inverse agonist monlunabant (INV-202), which showed a 3% weight reduction at day 28 compared to 0.5% with placebo.

While less impressive than the amycretin results, it shows proof-of-concept and Novo Nordisk is advancing a next-generation CBR1 drug (INV-347) into clinical testing.

There are obesity therapies ahead of the queue in Novo Nordisk’s pipeline, including an oral formulation of semaglutide, due to report phase 3 results later this year, as well as CagriSema, a once-weekly injectable combination of semaglutide and amylin analogue cagrilintide that should have late-stage data early next year.

The early-stage data shows that the company has compounds that could become a new generation of therapies as Wegovy comes to the end of its patent life in the early 2030s.

Novo Nordisk said that the launch of Wegovy had “unlocked” the obesity market, despite well-documented supply constraints, but that it is now expanding its focus beyond weight loss to improving overall health for people with obesity or who are overweight.

Semaglutide has already shown its value in reducing complications of being overweight, such as cardiovascular issues and kidney disease, and Novo Nordisk revealed new data pointing to a “clinically meaningful” improvement in osteoarthritis patients’ pain and physical function in the STEP 9 trial.