Amycretin Pops After CagriSema Drops on Similar Numbers
The race to innovate beyond semaglutide and tirzepatide for obesity can be utterly confusing. More than a hundred new drugs are in various stages of development and analysts expect more than a dozen to be launched within the next five years. But right now, all we have are tantalizing – and sometimes disappointing – results from ongoing clinical trial programs. The juicy tidbit of the week came yesterday with Novo Nordisk announcing topline numbers for amycretin in phase 1/2 that were not terribly different from numbers released a few weeks ago for CagriSema from a phase 3 study.
After 36 weeks, patients on a high dose of amycretin lost 22% of their initial weight. In the 68-week study of CagriSema, patients lost 23%. On the news of amycretin, the Novo Nordisk stock price popped up by 10%. In response to the CagriSema news, it dropped more than 20%.
Of course, comparisons of results from these two very different trials of very different drugs can be very misleading. But the radical difference in response from the stock market to similar numbers is at least a bit puzzling.
Targeting Amylin
One thing these two drugs have in common is that they target amylin receptors in addition to GLP-1. Scientists actually have quite a bit of experience with this drug target because of work at Amylin Pharmaceuticals two decades ago. David Kendall was an executive at that company and now is Executive Vice President and Chief Medical Officer at Zealand Pharma. The company is developing petrelintide, which targets the amylin receptor exclusively. On targeting this receptor, he says:
“I never lost interest. We believe that it can be a critically important, and maybe a backbone therapy, for obesity.”
Getting Through Phase 3
Belief is one thing, but getting to approval is quite another. This is why we scratch our head a bit when investors go wild with enthusiasm for phase 1/2 results (for amycretin) that are not awfully different from phase 3 results (for CagriSema) that made them despair.
Yes, amycretin is a very interesting drug and the results after only 36 weeks were impressive. The fact that it might have an oral form is also quite interesting. But lots can happen before a drug gets past the hurdle of phase 3 studies. CagriSema is clearing that hurdle. Many things beyond average weight loss numbers will start to define the utility of new drugs in this category.
So we are glad that amycretin, CagriSema, and petrelintide are making progress toward clearing the hurdles for FDA approval. But it is a little too early to have any confidence about which one will be market leader.
Click here, here, and here for the news on amycretin, here for perspective on targeting amylin receptors, here for more on CagriSema, and here for more on petrelintide.
Through a Magnifying Glass with Numbers, image by DALL·E 3 / Wikimedia Commons/em>
Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.
January 25, 2025