Sweet success for Pfizer in diabetes

Look out Novo Nordisk: early data suggest that Pfizer’s small-molecule GLP-1 agonist danuglipron could be a contender in diabetes. True, Pfizer still has a lot to do, but results with the highest dose tested in a phase 2 trial show promising HbA1c lowering and weight loss that, on a cross-trial basis, looks better than that seen with Novo’s oral GLP-1 Rybelsus. The project to beat now might be Lilly’s injectable GIP/GLP-1 agonist tirzepatide, and there is the possibility that danuglipron’s performance could improve, Pfizer’s chief scientific officer, Mikael Dolsten, suggested during the group’s fourth-quarter earnings call yesterday. First, the study was only 12 weeks long, and secondly Pfizer believes that it has yet to nail down the optimum dose titration. A new phase 2, looking at titration over up to a month, is due to start mid-year. Pfizer is already looking ahead of twice-daily danuglipron, and recently took a once-daily oral GLP-1, PF-07081532, into phase 1. However, this does not indicate a lack of faith in danuglipron, Mr Dolsten insisted: “I believe danuglipron has what it takes to go into a pivotal study.” The group might eventually test PF-07081532 and danuglipron in the same trial, he added.

Cross-trial comparison of data with GLP1-targeting projects
Project/product Company Trial HbA1c decrease Weight loss
Danuglipron (PF-06882961) 200mg bid Pfizer Ph2 12-wk C3421008 1.6% 5.4kg
Rybelsus (oral semaglutide) Novo Nordisk Ph3 26-week Pioneer 1 1.2-1.4% 2.3-3.7kg
Ozempic (injected semaglutide) Novo Nordisk Ph3 30-wk Sustain 1 1.4-1.6% 3.8-4.7kg
Tirzepatide* Lilly Ph3 40-wk Surpass-2 2.0-2.3% 7.6-11.2kg
*Dual GIP/GLP-1 agonist. Source: Company presentation, product labels & NEJM article.

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