Novo Nordisk and its Chinese partner have reported another midphase win for their triple G candidate, sharing diabetes data to add to the momentum generated by an obesity readout. But while the data suggest the asset is competitive, Eli Lilly’s headstart in the space means it remains the company to beat.
Last year, Novo paid The United Laboratories (TUL) $200 million upfront for ex-China rights to UBT251. Like Lilly’s retatrutide, UBT251 is a triple agonist of the GLP-1, GIP and glucagon receptors. Clinical trials have shown triple G agonists drive deeper weight loss than GLP-1 therapies such as Novo’s Wegovy and dual-target molecules including Lilly’s Zepbound.
Wednesday, TUL shared evidence that UBT251 is more effective than semaglutide—the GLP-1 drug that Novo sells as Ozempic and Wegovy—in people with Type 2 diabetes. The company’s United Biotechnology R&D unit generated the evidence in a phase 2 trial of 211 Chinese patients with Type 2 diabetes.
After 24 weeks of once-weekly injections, levels of the blood sugar measure HbA1c fell up to 2.16% in the UBT251 cohorts, compared to declines of 1.77% on semaglutide and 0.66% on placebo. Mean HbA1c was 8.12% at baseline.
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Lilly saw HbA1c reductions of up to 2.02% at Week 24 of its phase 2 retatrutide trial in people with Type 2 diabetes. The company also recently reported HbA1c reductions of up to 1.9% in a larger and longer phase 3 trial of retatrutide.
Novo and TUL reported mean body weight reductions of up to 9.8% in the UBT251 cohorts, versus 4.8% in the semaglutide group and 1.4% in the placebo arm. Lilly reported weight loss of up to 16.94% in its phase 2 trial, although at least some of the apparent advantage over UBT251 is explained by timing. The retatrutide trial measured weight loss at Week 36, compared to Week 24 in the UBT251 study.
The UBT251 study evaluated 2-mg, 4-mg and 6-mg doses of the drug candidate. Patients on semaglutide received a 1-mg dose. In the real world, people taking semaglutide for diabetes start with a 0.25-mg pen and titrate to doses of up to 2 mg. Semaglutide is given at doses of up to 7.2 mg to treat obesity. Lilly tested retatrutide at doses of up to 12 mg in people with Type 2 diabetes.
Encouraged by the Chinese data, Novo plans to start a global phase 2 trial of UBT251 in people with Type 2 diabetes in the second half of the year. The Danish drugmaker recently began a global phase 1b/2a trial in around 330 people with overweight or obesity. Novo expects topline data from the weight-loss trial in 2027.
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The timeline raises questions about UBT251’s commercial prospects. Lilly plans to file for FDA approval of retatrutide in obesity this year, with a diabetes submission scheduled to follow in 2027. If Lilly’s filings go to plan, retatrutide could come to market around the time that Novo enters phase 3.
Such considerations are coloring analysts’ expectations. Last month, BMO Capital Markets analysts said in a note to investors that the data on UBT251 in obesity “appear encouraging.” However, the analysts added that “with Novo significantly behind retatrutide’s clinical development timeline, [the] results have less significance in the near term.”
