"Novo Nordisk" wins by volume: High-dose trial of semaglutide shows 19% weight loss effect, but still lags behind Eli Lilly's competing products

Novo Nordisk recently announced the results of a clinical trial, showing that its highly anticipated Semaglutide demonstrated more significant weight loss effects when the dosage was increased threefold. Semaglutide is Novo Nordisk's flagship product, marketed under the weight loss drug brand Wegovy and the diabetes medication brand Ozempic. In the two latest Phase III clinical trials, researchers tested a 7.2 mg dose of Semaglutide, while the currently approved maximum dose is 2.4 mg. In the larger of the two trials, patients lost an average of 19% of their weight after 72 weeks. In comparison, patients using the standard dose of 2.4 mg lost an average of 16%, while the placebo group lost only 4%. However, this data still does not surpass the market leader Eli Lilly's Tirzepatide. Eli Lilly's drug, marketed under the brands Zepbound and Mounjaro, showed trial results with an average weight loss effect of up to 22.5% at its highest approved dose. High-Dose Option Shows Observable Increment, but Efficacy Still Lags Behind Eli Lilly Although it did not lead in maximum efficacy, the new high-dose option is still considered clinically significant. Naveed Sattar, a professor of metabolic medicine at the University of Glasgow, pointed out that this "incremental" benefit remains clinically important, especially considering that the price of Eli Lilly's high-dose Tirzepatide has significantly increased in certain regions. He believes: “If priced competitively, the 7.2 mg dose of Semaglutide will become a more affordable option.” Despite the new incremental potential brought by this trial data for Semaglutide, Novo Nordisk has faced numerous challenges in the market recently, not only losing market share to Eli Lilly and "compound" generics in the U.S. but also seeing its stock price drop by 60% over the past year. The company replaced its CEO in May and recently announced plans to lay off 9,000 employees. Safety Manageable but Side Effects Increase with Dosage While efficacy improves, the incidence of side effects also increases accordingly. Trial data shows that about 71% of participants using the 7.2 mg dose experienced gastrointestinal symptoms, compared to 61% in the current dose group. Additionally, over one-fifth of patients in the high-dose group reported abnormal sensations (skin sensation changes, sometimes accompanied by pain), which often requires a temporary reduction in dosage. The trials named STEP-UP and STEPUPT2D first validated whether increasing the Semaglutide dosage to three times could yield more weight loss effects. In the STEP-UP study, which included approximately 1,400 obese adults, nearly half of the patients using the 7.2 mg dose lost more than 20% of their weight, and one-third of the patients lost at least 25% Another smaller-scale trial targeting patients with obesity and type 2 diabetes showed that the high-dose group lost 13% of their weight, while the standard-dose group lost 10%, and the placebo group lost 4%. Both studies indicated improvements in participants' health indicators, including waist circumference, blood pressure, cholesterol, and blood sugar levels