Will the obesity treatment market Novo Nordisk and Lilly Yanggang-gu break?

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<p>[헬스코리아뉴스 / 이충만]  While Novo Nordisk of Denmark and Eli Lilly and Company of the United States are competing fiercely for leadership in the fattening obesity treatment market, Amgen of the United States has belatedly entered the competition.  At the same time as speeding up the development of a treatment, it emphasizes its superiority over existing drugs and is in fact moving busily to create a crack in the Yanggang composition.</p>

<p>Since 1996, when the World Health Organization (WHO) began to officially define obesity as a disease, the obesity treatment market began to heat up.  The world’s obese population is rapidly increasing, and it is considered to be the root of all diseases.  Given that obesity is a disease that requires long-term treatment and management, it is a good market for pharmaceutical companies developing medicines.  US investment bank Morgan Stanley predicts that the global obesity treatment market will reach $54 billion by 2030.</p>

<p>The first company to dominate the market is Novo Nordisk.  The company received approval from the U.S. Food and Drug Administration (FDA) for its glucagon-like peptide-1 (GLP-1) agonist, Saxenda (ingredient name: liraglutide), as an obesity treatment in December 2014. .  Since then, it has successfully introduced the follow-up new drug ‘Wegovy’ (ingredient name: semaglutide), dominating the related market.</p>

<p>In particular, GLP-1 agonists after ‘Saxenda’ are evaluated as suggesting a new paradigm for weight control.  Appetite suppressants, which have been widely used as obesity drugs until now, are psychotropic drugs containing narcotic components, which act on the central nervous system and cause side effects such as depression, lethargy, and emptiness.  On the other hand, GLP-1 agonists act on GLP-1, a hormone that makes you feel full by acting on the hypothalamus of the brain, activating incretin, an intestinal hormone, and promoting insulin production to lower blood sugar levels.  In this process, it slows down the movement of food from the stomach to the small intestine, increasing the feeling of fullness.</p>

<p>When Novo Nordisk monopolized the market, Lily stepped up to the brakes this time.  Lilly’s ‘Mounjaro’ (ingredient name: tirzepatide) is the world’s first GLP-1/GIP dual action metabolic disease drug that acts dually on the glucose-dependent insulinotropic polypeptide (GIP) receptor along with GLP-1. by launching a challenge to Novo Nordisk.</p>

<p>‘Maunjaro’ is presumed to reduce food intake and control metabolic disorders by weakening the metabolic adaptation response that occurs during diet control.  The U.S. Food and Drug Administration (FDA) first approved Maunjaro in May as a blood sugar control agent for adult patients with type 2 diabetes.  Although it was first known as a diabetes treatment, it has been highlighted as a promising obesity treatment by demonstrating its weight loss effect in obese patients in related clinical studies.</p>

<p>While competition between Novo Nordisk and Lilly is heating up in the obesity treatment market, Amgen has expressed its will to enter the market by sharing its initial research results on a new mechanism of obesity treatment drug.  In particular, the new drug being developed by Lilly is known to have proven more effective than ‘Wigobi’ or ‘Maunjaro’, foretelling a significant impact on the existing market.</p>

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‘AMG133’ shows weight loss effect for up to 150 days

Amgen presented phase 1 clinical trial data of its new anti-obesity drug candidate ‘AMG133’ at the World Congress on Insulin Resistance, Diabetes and Cardiovascular Diseases (WCIRDC) held in Los Angeles on the 3rd.

In this study, 110 obese adults with a BMI of 30 or more and less than 40 who did not suffer from diabetes were randomly administered ‘AMG133’ in various doses, once a month, along with a placebo for 12 weeks. As a result of the interim analysis of the test, the highest dose ‘AMG133’ administration group maintained the weight loss effect for about 70 days, and the average weight decreased by 14.5%. In some of them, weight loss of about 11.2% was maintained even after 150 days of the last administration. The most common adverse reaction of ‘AMG133’ was nausea or vomiting, but most were mild and disappeared within a few days after the first dose.

What stands out is that ‘AMG133’ proved its superiority in weight loss and maintenance ability compared to ‘Wigobi’ and ‘Maunjaro’. ‘Wigobi’ and ‘Maunjaro’ showed an average weight loss effect of 6% and 9%, respectively, for 12 weeks in a phase 1 study. In addition, while these drugs had to be administered once a week, ‘AMG133’ maintained its weight loss effect for up to five months.

Therefore, there is an analysis that if the development of ‘AMG133’ goes smoothly, it can emerge as a dark horse that can threaten existing strong players in the global obesity treatment market.

‘AMG133’ is the first GLP-1/GIPR dual agonist in its class that acts dually on GLP-1 and gastric motility inhibitory polypeptide (GIPR) receptors. It acts on GLP-1 but has a mechanism of antagonizing GIP, as opposed to ‘Maunjaro’. Amgen plans to initiate phase 2 clinical trials of ‘AMG133’ in the first half of next year.

Some criticize that regardless of the efficacy of ‘AMG133’, Amgen has joined the obesity treatment market too late and will not have a significant impact on the market. Some industry experts said, “Novo Nordisk and Lilly are showing promising efficacy in diabetes as well as obesity, but ‘AMG133’ only proved effective in weight loss.” predicted that

JP Morgan analyst Chris Schott predicted, “Even if everything goes well, the phase 3 clinical study of ‘AMG133′ will begin in 2024, and health authorities’ approval will come after that, in 2026 or 2027.” .

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