As the demand for injections to lose weight has become popular, alternatives to current Ozempic type treatments, Wegovy (semaglutida) or Mounjaro (Tirzepatida) also grow. The most advanced is orforglipron, a simple daily intake pill, the oral LLP-1 of Lilly, which could get to unseat weekly injections.
There are several advantages, as two recently published studies have demonstrated. Thus, in addition to the comfort it supposes for many not to have to prick, the clinical trial in phase 3 «Attain-1», published in «The New England Journal of Medicine», and that evaluates the safety and efficacy of orforglipron in adults with obesity (or overweight with a medical problem related to weight) and without diabetes, the oral glp-1 of Lilly demonstrated an average weight reduction of 11.2%. Specifically, more than half of the 3,127 patients who were followed for 72 weeks lost at least 10% of its weight and approximately 18% reducing it by more than 20%.
The participants were randomly assigned to different doses of orforglipron (6 mg, 12 mg or 36 mg) or placebo, always in the form of a daily capsule.
The results show that among patients who received the highest dose of orforglipron (36 mg), 54.6% had a reduction of 10% or more, 36% had a reduction of 15% or more and 18.4% had a reduction of 20% or more of their weight, compared to 12.9%, 5.9% and 2.8% of patients, respectively, respectively, in the placebo group.
But not only achieves improvements regarding placebo, as demonstrated by the study «Achieve-3», a clinical trial in phase 3 that compares orforglipron with the oral semaglutida (Rybelsus is the existing oral format of the same active substance of Ozempic) in patients with type 2 diabetes.
The 52 -week test (pending publishing in a peer reviewed magazine) compared orforglipron with oral semaglutida through four active treatment arms to evaluate glycemic control and weight loss.
The results are conclusive: «A Glycosylated hemoglobin reduction (HBA1C) and an improvement in glycemic control And also a reduction of the greater weight, ”says Spanish doctor and researcher Fernando Gómez Peralta, coordinator of the Diabetes Knowledge Area in the Spanish Society of Endocrinology and Nutrition (SEEN).
Specifically, Orforglipron reduced HBA1C in an average of 1.9% (with the dose of 12 mg) compared to 1.1% (7 mg) and 1.4% (14 mg) achieved with the oral semaglutida at 52 weeks.
In addition, 37.1% of the participants with the highest dose of Orforglipron achieved an HBA1C level less than 5.7% (that is, Normaglucemia) compared to 12.5% of the participants who received the highest dose of oral semaglutida.
As for the weight reduction,Lilly oral LP-1 was more effective than oral ozempic. The participants who took orforglipron They lost an average of 6.6 kg (6.7% weight reduction among participants who took 12 mg of this drug) and 8.95 kg (9.2%; 36 mg) compared to 3.6 kg (3.7%; 7 mg) and 5 kg (5.3%; 14 mg) that those who received oral semaglutida, which represents a relative weight loss by 73.6% higher in the highest dose comparison. That is to say3.95 kg less a year.
And not only. Orforglipron also showed clinically significant improvements against non-HDL cholesterol, systolic blood pressure and triglycerides.
Regarding the injectable semaglutid, although this study in question does not make this comparison, The SEEN spokesman ensures “that glycemic control improvements and weight reduction are similar to those achieved with the injection semagglutid according to data from other studies »in which the advantages of injectables were analyzed.
But the benefits do not end there. The only oral treatment authorized today, Rybelsus, is a protein, a large molecule that, so that it is not disintegrated in the stomach, requires coverage that limits its bioavailability so that less than 10% of the semaglutidal that is taken orally reaches the blood and is effective. Hence Rybelsus has to take 30 minutes before breakfastwhich can limit adhesion to treatment, since we all rush in the morning.
That is why in his day when there was the shortage of Ozempic, many patients preferred to return to the weekly injection when this problem was solved.
But the future drug of Lilly could increase adhesion in the therapeutic approach of metabolic disease, since this compressed oral administration «It can be taken at any time of the day, before or after meals, Because it is not a protein, but they are small molecules of more sustainable and accessible manufacturing both in terms of prices and easy intake. And its conservation is also superior, ”says the doctor.
Assessment
As for tolerance to the future drug, the SEEN spokesman explains «This was very good according to the trials, just like the rest of its class. The adverse effects reported were light or moderate (nausea and vomiting the most frequent) and in no case forced to interrupt the treatments. Besides, Serious liver events had no place »which is what led to the suspension of another oral drug to lose weight of another laboratory, Danuglipron.
Given these results, Lilly is working to make the world regulatory applications for the treatment of obesity, which is expected to occur next year. The sending of data for the processing of type 2 diabetes is planned for 2026. so that «Hopefully we can have it available in Spain at the end of 2026 or early 2027. But it is a hope», Affects Dr. Gómez Peralta.
And it has the advantage that “as it is a small molecule it could occur in our country,” he adds.
The laboratory is also stepping on the accelerator Novo Nordiskwhich has communicated favorable results for the Wegovy in daily oral pill format. Your pill to lose weight has achieved, As published, an almost as high weight loss as its weekly injection version Wegovy in the last essay for obese or overweight patients without diabetes.
As for the times, this pill is being evaluated by the US health authority, which must issue its decision at the end of the year. But Novo Nordisk is already preparing for marketing in 2026.
Now, whether a treatment or another, it is important to know that GLP-1 medications such as semaglutida (active ingredient in Ozempic and Wegovy) is more dangerous for health than bariatric surgery, despite what was believed so far.
Thus, according to an investigation published this month in “Nature Medicine” although bariatric surgery is a more invasive procedure, the truth is that undergoing this intervention reduces the risks of death, heart disease, renal insufficiency and ocular damage in the face of taking antiobesity drugs.
And not only. This summer a study by the University of New York concluded that those who go through bariatric surgery tend to lose much more weight than those who take GLP-1 medicines.