When Roche unveiled its long-awaited obesity strategy yesterday, it included a bold goal of becoming one of the “top three” companies operating in the weight loss space.
But, while current obesity leaders Eli Lilly and Novo Nordisk both dominated the market with a single blockbuster asset—in the form of Mounjaro and Wegovy, respectively—Roche’s head of metabolic product development told Fierce Biotech that the Swiss pharma is taking a different approach.
“I don't buy into this idea that you need to have this one megablockbuster that will make you [an obesity leader],” said Manu Chakravarthy, M.D., Ph.D., global head of cardiovascular, renal and metabolism product development at Roche.
“In fact, I would submit that if you only had that, you would be severely handicapped in addressing the complexity and the heterogeneity of what we know the obesity market is,” he said in an interview.
Roche’s strategy includes an aim of taking the dual GLP-1/GIP receptor CT-388 to market by 2030. The asset—which was acquired as part of the $2.7 billion buyout of Carmot Therapeutics—is due to enter a phase 3 study in the first half of next year.
Speaking to Fierce after his own presentation at Roche’s Pharma Day yesterday, Chakravarthy said the company is currently working “on full cylinders” to get the phase 3 trial launched on schedule.
When asked by Fierce whether getting a phase-2-stage obesity drug to market within five years is too ambitious, Chakravarthy pointed to ways the company is continuing to “build our core capabilities.” This included on the manufacturing side, where the pharma recently broke ground on a $700 million plant in North Carolina that will be charged with, among other things, performing fill-finish duties for the company's injectable obesity drugs.
“If we didn't have any of those kinds of pieces yet then I think, yes, I would be very concerned that we would not be able to move into 2030,” he explained. “But we have those things now, and those investments that have already been made is what gives us the confidence that we're on the path towards getting there.”
“Now … being somewhat of a competitive guy, I would love for it to be moved a little bit earlier than 2030,” Chakravarthy added. “We have to have the ambition, but we also want to be realistic.”
The pharma will likely “refine the guidance on the timelines” for CT-388 next year when the phase 3 trial kicks off, he said.
Roche also has another Carmot asset in phase 2 studies in the form of an oral GLP-1 dubbed CT-996. Then there’s petrelintide, Zealand Pharma’s long-acting amylin analog that Roche is partnering on.
Finally, the company used its presentation to highlight emugrobart, an anti-latent myostatin sweeping antibody that is designed to increase muscle mass. Emugrobart has its origins at Roche’s Chugai subsidiary and is currently being studied in a phase 2 study in combination with Lilly’s Mounjaro.
Headlining the company’s Pharma Day in London on Monday, Roche Pharma CEO Teresa Graham boasted of having “one of the broadest obesity portfolios out there.”
Chakravarthy backed up this claim, pointing out that the company’s own patient and market research had confirmed the need for a varied offering.
For example, the combination of CT-388 and petrelintide could help patients who haven’t reached a suitable level of weight loss on a single treatment, he said.
“Then there are people who just are not tolerating a certain class of medicines,” Chakravarthy added. “Whether it's 388 or petre[lintide], you need optionality in your portfolio to give people other things.
“If you don't have optionality … they'll go to somebody else,” he explained. “We want everybody who is going to be treated on the obesity pathway to be on Roche products.”
The Swiss pharma also has ambitions when it comes to the comorbidities of obesity. This is where the phase 3-stage fatty liver disease drug pegozafermin, acquired as part of the buyout of 89bio last week, comes into play.
Chakravarthy even suggested that one day the company “may think about” how Roche’s investigational Alzheimer’s disease drug trontinemab could play a role in its broader obesity offering. Obesity is considered a risk factor for dementia.
“That's a dream right now, but, you know, that could happen,” he said.
In the near term, Roche has a raft of phase 2 readouts coming next year that will bring the company’s lofty obesity ambitions back to Earth. They include a pair of studies for petrelintide as well as readouts for CT-388 and CT-996.
On top of this, Chakravarthy expects phase 2 data to show whether the emugrobart-Mounjaro combo affects “weight loss and the preservation of lean mass.”
“So it’s going to be a busy 2026,” he said. “And while we're getting all of that, we're also planning on initiating some key studies.”
At the same time Roche was fleshing out this obesity timeline yesterday, Pfizer was redoubling its own efforts in the weight loss space by announcing the $4.9 billion acquisition of Metsera for its clinical-stage incretin and amylin programs.
So, can we expect Roche to also make another major M&A play in the obesity space?
“It would be remiss of me to say we are not going to follow the science, because this is an ever-evolving, ever-changing landscape, right?” Chakravarthy said. “We will constantly be looking to make sure that we are bolstering our pipeline to be as competitive as possible.”
When pushed by Fierce on what sort of obesity asset is most likely to attract Roche’s attention, Chakravarthy suggested a “weight maintenance” drug.
“We've done a very good job as an industry to drive weight down,” he explained. “But I think the bigger challenge for us right now is: How do you keep people who have lost the weight and maintain that weight loss over a long, sustainable period of time?”