Pharmaceutical companies are pursuing amylin-based therapies as a next wave of obesity and Type 2 diabetes treatments, either as standalone drugs or combinations with established GLP-1 medications. Amylin is a hormone released by the pancreas that regulates hunger and fullness through a different biological pathway than GLP-1 drugs, offering potential additional weight loss benefits when used together.
Eli Lilly presented results this week from a Phase 2 trial of eloralintide combined with tirzepatide, its blockbuster obesity drug. Patients receiving the highest-dose combination lost an average of 23.3% of body weight at 48 weeks, compared with 14.8% for those taking tirzepatide alone. Lilly is developing eloralintide both independently and as a combination therapy, with analysts projecting significant commercial potential. The company plans to begin Phase 3 trials later this year and aims to address tolerability concerns, as 10.8% to 27% of combination therapy patients discontinued treatment due to side effects, depending on dosage.
Novo Nordisk is pursuing a similar strategy with cagrilintide, an experimental amylin drug showing meaningful weight loss in late-stage trials. The company’s combination treatment, CagriSema, is expected to launch early next year, with standalone cagrilintide and higher-dose formulations following in 2028. Novo is also developing amycretin, a single molecule targeting both GLP-1 and amylin pathways, currently in Phase 2 testing as both a weekly injection and daily oral tablet. Recent data on CagriSema indicated benefits beyond weight loss, including reduced thoughts about food and improvements in organ and bone health.
Several other companies, including Pfizer, AstraZeneca, and Viking Therapeutics, are developing their own amylin products. Industry analysts estimate that over 10 million people have not achieved adequate results from existing GLP-1 therapies due to efficacy concerns, side effects, or genetic factors. The new generation of amylin drugs are designed as long-acting formulations taken once weekly, representing improvements over the first approved amylin therapy from more than two decades ago, which required multiple daily injections and saw limited adoption.
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