Rising Fog

Semaglutide Coming on Strong

The decade just past brought quite a bit of change in drugs used to treat obesity. At the beginning of the decade, options were few. Prescribing was almost nil. Now we have five new drugs for obesity. For type 2 diabetes, weight-sparing drugs have taken a dominant role in prescribing. One of those drugs, liraglutide, has become a runaway success in a higher dose for obesity. Sold under the brand name Saxenda, Novo Nordisk revealed this week that 2019 sales reached more than $800 million. That reflects impressive growth of 42 percent over 2018. But even more impressive is the incredibly strong start for semaglutide, which is liraglutide’s successor.

Semaglutide is an improved version of liraglutide that can be taken only once a week. Last year marked the first full year of its availability for treating type 2 diabetes. Already it’s a blockbuster. Sales for 2019 surpassed $1.6 billion.

Lofty Ambitions

Novo Nordisk Obesity Goals

Novo Nordisk has been quite clear. Its goal is to close the gap in efficacy between bariatric surgery and drug therapy for obesity. In other words, to deliver the effectiveness of bariatric surgery without the surgery.

That is a tall ambition. Like any big goal, the pathway is marked by a series of smaller steps. Semaglutide is the next step and so far, it looks good. However, the real test will come when definitive phase three studies emerge later this year and undergo peer review. Novo Nordisk revealed yesterday that this milestone will come sometime in the middle of this year.

If that goes well, we could see a submission to FDA and approval in 2021.

More to Come

Meanwhile, other developments are moving forward. An oral form of semaglutide is launching for type 2 diabetes and it promises to be another blockbuster. Getting rid of the needles might seem like a small thing, but for patients, it’s huge.

And then there’s AM833 – a long-acting amylin analogue. Phase 2 results for this anti-obesity medicine are due in the first half of this year. Best of all, Novo Nordisk’s success is serving as both a model and a stimulus for competitors who promise to bring yet more options into market.

With any luck, more options can translate into better outcomes for people living with obesity. It can’t come fast enough.

Click here for further perspective and here for the Novo Nordisk presentation of results and plans.

Rising Fog, photograph © Maurizio Fecchio / flickr

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February 7, 2020