When looking out across the competitive GLP-1 landscape, AstraZeneca might not be the first Big Pharma name that comes to mind for many industry watchers. But with a pair of phase 2b readouts at the American Diabetes Association scientific sessions, the company is increasingly putting itself on the map.
Late Monday, AZ shared details behind its midstage Vista and Solstice trial wins for elecoglipron, its oral small molecule GLP-1 receptor agonist. The company already disclosed in February that the trials had turned out positive results, but the newly revealed data are giving analysts reason for optimism.
In the Vista phase 2b trial, AstraZeneca reported that adults with obesity or overweight and at least one comorbidity experienced average body weight reductions of 10.5% after 26 weeks on daily 75 mg elecoglipron compared with 0.6% for placebo, meeting one of the study’s dual primary endpoints.
The weight loss figures reached 11.8% in the treatment arm and 0.3% for placebo after 36 weeks, the company said, noting that “weight loss in participants receiving elecoglipron did not plateau.”
In a note to clients Monday, analysts with Jefferies noted that the results are numerically “higher than we have seen with other key oral small-molecule GLP-1 agents.”
On the study’s other dual primary endpoint, AZ said the proportion of patients achieving at least 5% weight loss at 26 weeks reached “up to 88.8%,” which was enough for a positive finding. The company touted further “clinically meaningful improvements in several exploratory analyses of cardiometabolic risk factors” such as those related to blood pressure and a marker of inflammation.
Moving over to the Solstice trial in patients with Type 2 diabetes, AZ reports that elecoglipron showed an average reduction in HbA1c of 1.9% from baseline at 26 weeks, compared with 0.2% for placebo, meeting the primary endpoint.
In this trial, the majority of patients achieved guideline-recommended glycemic targets at that same 26-week time point, AZ said. Nine out of 10 reached an HbA1c of less than 7%, and the drug was associated with a “clinically meaningful” average weight reduction of 7.7% versus 1.7% for placebo, the company added.
On safety, the British drugmaker described an adverse event profile that was “predominantly gastrointestinal and of mild to moderate severity” in the trials. The most common adverse events were nausea, constipation, diarrhea, and vomiting, with more cases reported in both treatment arms versus their respective placebo arms.
Adverse events leading to discontinuation “were infrequent in both trials and no liver safety signals were observed,” AZ explained.
Overall, the Jefferies analysts said the elecoglipron data come in “ahead of expectations” and position AZ to “make a strong case for weight management combinations.” They touted what they saw as “competitive efficacy with standard tolerability.”
As it stands, the consensus estimate is for AstraZeneca to generate $1 billion in obesity revenues in 2031, so the company is in a position where any meaningful progress in the booming field “represents upside optionality,” the analysts said.
Now, AZ is ready to put more chips behind the candidate. In its Monday release, the company laid out plans to run the Embold phase 3 study in patients with obesity or overweight, with or without Type 2 diabetes. Additionally, it’s gearing up for the Eluminate trials assessing the drug as a monotherapy and in combination with AZ’s own SGLT2 inhibitor Farxiga as a treatment for patients with type 2 diabetes.
Beyond those are plans for long-term cardiovascular and kidney outcomes studies.
Besides elecoglipron, AZ’s weight loss portfolio includes the long-acting amylin AZD6234 and several recent additions from its high-profile deal in January with China’s CSPC Pharmaceutical.