Novo Nordisk looks towards a skinny pill

What if the “skinny jab” were a pill? The oral version of Novo Nordisk’s obesity treatment Wegovy scored yesterday in its pivotal Oasis-1 study, and actually came in marginally better than its subcutaneous cousin. Novo did not go into great detail on safety, saying that the most common adverse events were gastrointestinal, with the vast majority being mild to moderate and consistent with the GLP-1 class. Filings will come this year, the group said; an oral version of the same compound, semaglutide, is already approved in diabetes as Rybelsus. Here, Novo is ahead of its arch-rival Lilly, which does not appear interested in developing an oral form of its highly impressive GIP/GLP-1 agonist Mounjaro. Novo is also ahead of Pfizer. Phase 2 data on that group’s oral GLP-1 danuglipron in diabetes, published yesterday, showed statistically significant improvements in blood sugar and body weight versus placebo at four months – but that pill must be taken twice daily, and it is not likely to be a serious competitor to oral Wegovy. Indeed the only cloud on Novo’s horizon is the major problem of ramping up sufficient production capacity.  

Wegovy SC vs oral: cross-trial comparison 
Trial Step 1 (ph3, NCT03548935) Oasis 1 (ph3, NCT05035095)
Project and dose Wegovy SC 2.4mg once weekly Placebo Wegovy oral 50mg once daily Placebo
Weight loss at 68wk 14.9% 2.4% 15.1% 2.4%
Pts achieving 5% weight loss or more at 68wk 86.4% 31.5% 84.9% 25.8%
Figures given for treatment policy estimand. Source: company communications & NEJM  

Share This Article