Eli Lilly is the manufacturer of successful Tirzepatide of the Glp-1 drug, approved as Mounjaro for type 2 diabetes and Zepbound for chronic weight management and the obstructive sleep apnea. Like Ozembic and Wegovy of Novo Nordisk, both Tirzepatide drugs of Eli Lilly are injected on a weekly basis. But some patients are afraid of needles or would prefer to remove a pill for convenience.
“What we see is that the effectiveness, safety and tolerability are really consistent with the best injectable GLP-1s,” says Kenneth Custer, president of the Cariometabolical Health of Eli Lilly, of the experimental pills of the company. “We think this is a big problem.” The company plans to request regulatory approval for ORFORGLIPRON for weight management by the end of this year and for the treatment of type 2 diabetes in 2026.
The 40-week experimentation tested three doses of ORforglipron-3 milligrams, 12 milligrams and 36 milligrams-a placebo in 559 patients with type 2 diabetes. All three doses were effective to lower blood sugar, while the medium and higher doses showed clinically significant and statistically significant reductions in body weight. The highest dose of Orforglipron led to an average weight loss of 7.9 percent or 16 pounds, comparable to the amount of weight loss observed in the same period in the tests of trafficlutide and tirzepatide. Eli Lilly is studying the pill in a longer study in people who are overweight or have obesity to see if the loss of weight continues.
In the current process, the participants took the pill once a day without restrictions on food or water. Those who were randomly assigned to Orforglipron started the study at a dose of 1 milligramo per day and slowly increased the dose at four weeks intervals. The current GLP-1 drugs are gradually increased in dose and to minimize potential side effects.
Orforglipron has shown similar gastrointestinal side effects compared to other GLP-1 drugs, with the most common of diarrhea, nausea, indigestion and constipation. Between 4 and 8 percent of the participants in the various dosage groups they abandoned the side effects, while 1 percent in the placebo group interrupted the study.
An oral version of traffic lights, sold with the Rybelsus brand, is on the market since 2019 but is not approved for weight management and is not effective for weight loss as injectable GLP-1. A pill specifically for obesity would give patients more treatment options and potentially would make these drugs more accessible.
The pills are generally less expensive to produce and can be produced in series more easily, making them less inclined to deficiency. (The injected GLP-1 drugs were lacking until recently.) The pills can also be transported more easily. The current penne of the GLP-1-tender must be sent and kept in the refrigerator to maintain their power. A GLP-1 pill would not need sophisticated distribution and conservation of the cold chain, which means that it could be sold in countries that do not have such an infrastructure.
“With ORforglipron that offers further advantages such as the elimination of rigorous pre-dosage requirements, potential lower costs and easier storage, it will be important to see if these characteristics lead to greater adherence,” says Priya Jaisinghani, a specialist in diabetes and obesity medicine at the New York Langone. “Like most chronic therapies, GLP-1s are more effective if used consistently, therefore a formulation that encourages long-term use could have a significant impact on patient results.”
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