Pharmaceutical companies including Eli Lilly and Novo are pursuing amylin-based therapies as the next generation of obesity and Type 2 diabetes treatments. Rather than replacing existing GLP-1 medications, these drugs are designed to work alongside or independently from current blockbuster therapies to provide additional weight loss benefits or alternative options for patients who do not respond adequately to GLP-1s.
Lilly’s experimental drug eloralintide demonstrated promising results this week in a Phase 2 trial when combined with tirzepatide, the active ingredient in Zepbound and Mounjaro. Patients receiving the highest-dose combination achieved an average weight loss of 23.3% of body weight at 48 weeks, compared to 14.8% for those taking tirzepatide alone. Analysts estimate the eloralintide franchise could generate approximately $23.2 billion in annual sales by the end of 2035, with standalone availability potentially beginning in 2029 and combination therapy launching in 2030.
Amylin, a pancreatic hormone involved in regulating hunger and fullness, activates a different biological pathway than GLP-1, potentially allowing for enhanced weight loss through multiple mechanisms. Lilly plans to advance eloralintide through Phase 3 trials beginning later this year, though tolerability remains a concern. In the Phase 2 study, discontinuation rates due to side effects ranged from 10.8% to 27% depending on dosage, compared to 2.9% for tirzepatide alone.
Novo is similarly pursuing amylin-based strategies, with its drug cagrilintide showing meaningful weight loss as a standalone treatment. The combination therapy CagriSema is expected to launch early next year. Novo is also developing amycretin, a single molecule targeting both GLP-1 and amylin pathways, which demonstrated promising Phase 2 results earlier this year. Additional companies including Pfizer, AstraZeneca, and Viking Therapeutics are developing their own amylin products, indicating broad industry interest in this therapeutic approach.
Experts note that improved formulations allowing once-weekly dosing represent a significant advancement over earlier amylin therapies approved more than two decades ago, which required multiple daily injections and achieved limited adoption. Preliminary data from Novo suggest benefits may extend beyond weight loss to include reduced appetite-related thoughts and improvements in organ and bone health markers.
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