Rewind helps Lilly move forward in diabetes

Tick. Lilly’s Trulicity has joined the now slightly less exclusive club of diabetes drugs able to demonstrate a cardiovascular benefit. The celebrations, however, will be muted as the full extent of that benefit will not be known until the group presents complete data at the ADA conference in June. However, Evercore ISI’s Umer Raffat believes that Lilly would not have used the words “compelling” without being confident that the hazard ratio in the trial would be similar to that of other GLP-1s. If his predictions are true then Trulicity’s results might beat Novo Nordisk's GLP-1 agonist Victoza, which has previously shown a 13% reduction in cardiovascular risk. The Rewind trial also puts Trulicity on the front foot with Ozempic, which does not have a cardiovascular benefit claim on its US label. Investors will also have noted that Trulicity was tested in a large group of patients who had not previously suffered any cardiovascular event, potentially hinting at a protective function. Lilly has, however, managed to steal some of its own thunder with LY3298176, a combination GIP and GLP-1 agonist, which last month beat Trulicity in both glucose reduction and weight loss. The strength of the benefit from LY3298176 has led some to speculate that in the longer term the industry will switch to GIP/GLP-1 combinations. But for now Lilly will be happy with the 3% share price lift from Rewind.

Top GLP-1 agonists by 2024e sales
  Sales ($bn)
Product Company 2018e 2024e
Trulicity Lilly 3.07 4.89
Ozempic  Novo Nordisk 0.21 4.25
Semaglutide Oral  Novo Nordisk 0.00 2.23
Saxenda  Novo Nordisk 0.57 1.04
Victoza* Novo Nordisk 3.90 0.87
Other   0.26 0.30
*US labels states CV benefit.

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