Eli Lilly has shared phase 1 data on amylin analog eloralintide, impressing analysts with results that point to the potential for the drug candidate to form part of a market-leading Zepbound combination.
Amylin has emerged as the next hot target in obesity. AbbVie and Roche bought their way into the race with multibillion-dollar deals. The drugmakers are part of a pack led by Novo Nordisk, which combined an amylin analog with GLP-1 drug semaglutide to create CagriSema. Lilly is further back, but phase 1 data suggest that, as happened in GLP-1, it has a shot at coming from behind to take a big slice of the market.
The Big Pharma shared phase 1 data ahead of the American Diabetes Association conference. The trial enrolled 100 patients to receive a range of doses of eloralintide. Weight loss after 12 weeks topped out at 11.3% but was as low as 2.6% in one of the dose cohorts.
Part of the appeal of amylin analogs is the potential to drive weight loss without causing the same level of tolerability problems as GLP-1 receptor agonists. Lilly reported relatively low rates of gastrointestinal adverse events, with 10% of people having diarrhea and fewer patients suffering nausea or vomiting.
Cantor Fitzgerald analyst Prakhar Agrawal said the data “look particularly strong” in a note to investors seen by Bloomberg. Jefferies analyst Akash Tewari was similarly upbeat. Reuters quoted Tewari as saying the successor to tirzepatide, the all-conquering GLP-1/GIP drug Lilly sells as Mounjaro and Zepbound, could be a combination of tirzepatide and eloralintide.
The presentation of the eloralintide data, which is scheduled for June 22, could provide a clearer picture of the risks and benefits of the drug candidate. Beyond that, Lilly still needs to share data from a phase 1 eloralintide-tirzepatide combination study it started in April and show whether weight loss continues to deepen beyond Week 12.
Deepening weight loss is a characteristic of GLP-1 receptor agonists, but there are outstanding questions about the longer-term effects of amylin analogs. The CEO of Zealand Pharma, which is partnered with Roche on amylin, questioned the durability of Lilly’s amylin-selective approach at a Goldman Sachs event last week. Zealand sees benefits to engaging two amylin receptors and the calcitonin receptor.
“I think in order to achieve a molecule that can provide a true alternative, with a significant weight loss as a monotherapy, you probably want to be on all three receptors,” Zealand CEO Adam Steensberg said. “If you're only on two, maybe you get into some issues at the higher doses where you also see the higher weight losses. That is something we would speculate.”
Competitors are waiting to capitalize on any weaknesses shown by the molecules. Lilly faces competition for the amylin opportunity from companies including AbbVie, Metsera, Novo and Roche, plus rivals with a range of different mechanisms, routes of administration and dosing frequencies.