A groundbreaking clinical trial has revealed that orforglipron, a new oral medication, may provide a more effective alternative for weight loss compared to existing treatments for individuals living with type 2 diabetes. This daily pill, developed by Eli Lilly, has shown the potential to help patients shed an average of 6-8% of their body weight, surpassing the results achieved with oral semaglutide.
Promising Results from Phase 3 Trials
The Achieve-3 trial, which involved over 1,500 adults across 131 medical research centres in countries such as Argentina, China, Japan, Mexico, and the United States, assessed the effectiveness of orforglipron against oral semaglutide. Participants received either 12mg or 36mg doses of orforglipron or 7mg or 14mg doses of oral semaglutide over the course of one year. The results indicated that those taking orforglipron not only experienced significantly greater weight loss but also achieved lower average blood sugar levels compared to those on oral semaglutide.
While the findings are encouraging, it’s important to note that the trial also reported higher rates of treatment discontinuation among those taking orforglipron. About 9-10% of participants stopped the medication due to side effects, primarily gastrointestinal issues, compared to 4-5% in the semaglutide groups.
Regulatory Status and Future Implications
Currently, orforglipron remains unapproved by regulatory authorities in the UK, US, or Europe, although the US Food and Drug Administration is presently reviewing the drug. At this time, semaglutide is the only GLP-1 medication available in pill form for type 2 diabetes in the United States, with its brand name Rybelsus. The injectable versions of semaglutide, such as Ozempic and Wegovy, have been shown to be more effective for weight loss than the oral option.
Experts believe that the advent of tablet formulations could revolutionise treatment for diabetes and obesity, offering patients a more convenient and potentially cost-effective solution. Tam Fry, chair of the National Obesity Forum, expressed optimism about orforglipron’s potential, stating, “Orforglipron could prove itself as the treatment of choice for the very obese diabetic,” emphasising the importance of careful regulation upon its release.
Expert Opinions on Long-Term Efficacy
Despite the positive outcomes of the trial, experts caution that the study’s one-year duration limits the understanding of long-term safety and effectiveness. Dr Marie Spreckley from the MRC Epidemiology Unit at the University of Cambridge highlighted the significance of the higher discontinuation rates, which could affect real-world adherence to treatment. She noted that further research is needed to address questions surrounding long-term safety and cardiovascular outcomes.
Naveed Sattar, a professor of cardiometabolic medicine at the University of Glasgow, reinforced the importance of effective oral medications in managing type 2 diabetes. He stated, “The more effective oral medicines we have to help people with type 2 diabetes lose weight and keep it off, the better,” advocating for a holistic approach that targets weight, blood sugar, and cardiovascular risk.
Why it Matters
The development of orforglipron represents a significant advancement in the ongoing battle against obesity and type 2 diabetes, conditions that affect millions worldwide. With its potential to offer a more user-friendly treatment option, this medication may transform the landscape of diabetes care, making it easier for patients to manage their weight and improve their overall health. As regulatory bodies continue to evaluate its safety and efficacy, the hope is that orforglipron will soon be available to those who need it most, providing a new avenue for better health outcomes.
