Hope for new low cost slimming pill as daily tablet beats oral semaglutide in trial
A new pill could help patients lose more weight than current oral weight loss medications, a promising new study has found.
The drug, called orforglipron, is a GLP-1 agonist and targets the same appetite receptors as fat jabs such as Mounjaro, Wegovy and Ozempic, but is taken in tablet form rather than administered via injection.
Orforglipron has been developed to treat type 2 diabetes and as part of a review by the U.S. Food and Drug Administration ( FDA ) was compared to an existing medication, oral semaglutide, sold under the brand name Rybelsus.
Rybelsus and the Wegovy Pill – which launched in the US in January and NHS chiefs hope to roll out in the UK by the end of this year – are the same medication, but the former is approved for the treatment of type 2 diabetes and the latter for weight loss.
In a trial of over 1,500 patients from Argentina, China, Japan Mexico and the US, patients who took orforglipron for a year experienced a greater drop in blood sugar levels and lost more weight than those on semaglutide.
In the study, 1,698 participants were randomly assigned to receive either orforglipron, at a dose of 12mg or 36mg, or oral semaglutide, at 7mg or 14mg.
Participants took their medication every day for a year, starting on a lower dose and increasing every four weeks until reaching their randomly assigned dose.
Results showed that both doses of orforglipron were better than that of semaglutide in reducing blood glucose levels, and they also lost more weight.
The new drug was tested against the diabetes treatment version of the Wegovy pill
Patients with type 2 diabetes are recommended to lose between 5-15 per cent body weight to help manage their condition, with a more than 10 per cent reduction having disease-modifying effects including potential remission.
Up to 43 per cent of participants on orforglipron were able to drop at least 10 per cent body weight, while only 21 per cent of those on semaglutide dropped enough weight to slash their risk of heart complications.
However, the weight loss seen among people taking orforglipron was not as extreme as results seen in patients taking Mounjaro, which contains the active ingredient tirzepatide.
Orforglipron can also be taken with food, making it much more convenient than semaglutide, which needs to be taken on an empty stomach. Experts have already stated that they believe GLP-1 tablets will be more accessible than injections – and potentially in the future, more affordable due to different packaging, storage and shipment requirements.
Writing in medical journal The Lancet, the authors said: ‘Our results suggest that orforglipron represents an important advancement in the oral treatment landscape for type2 diabetes.
‘It’s efficacy, safety, tolerability, and simple doing could address important barriers associated with current therapies, offering a new highly efficacious and safe option for individuals seeking glycemic and weight control with the use of injections.’
The researchers noted the difference in blood sugar control was already significant after just a month of treatment and was sustained until the end of the trial.
The results were particularly strong for patients with higher blood sugar levels at the start of the trial.
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Around a quarter of patients taking orforglipron managed to reach near-normal blood sugar levels during the course of the study whilst only around 12 per cent of those on semaglutide managed to reduce their blood sugar to safe levels.
If approved, orforglipron (which like Mounjaro, is manufactured by Eli Lily) could become the next GLP-1 drug approved for use ‘off label’ for weight management.
Weight loss jabs have transformed obesity treatment, offering dramatic weight loss that was largely out of reach with diet and exercise alone.
Two in three Britons are now overweight or obese, driving a nearly 40 per cent rise in type 2 diabetes among under 40s.
The researchers concluded: ‘Orforglipron represents meaningful improvements in glycemic control and weight reduction compared with oral semaglutide in patients with type 2 diabetes, and with larger improvements in cardiometabolic risk factors and simplified administration.’
However, during the course of the study around 10 per cent of participants on orforglipron had to stop taking the pill due to adverse reactions, such as gastrointestinal issues.
Only 5 per cent of patients taking semaglutide experienced similar adverse reactions.