The race to develop more effective obesity treatments is heating up. This week, Novo Nordisk Office has partnered that people taking the mega-dose version of semaglutide lost more body weight than usual in a large trial.

Novo Nordisk’s STEP UP trial involved more than 1,400 people with obesity, some of whom were randomized to receive a 7.2 milligram dose of semaglutide. People who stayed on this dose lost about 20% of their baseline weight over a 72-week period. The findings surpass the average weight loss results seen with the current semaglutide-based drugs Ozempic and Wegovy.

Semaglutide mimics the hormone GLP-1, which helps regulate our hunger and metabolism. It is the active ingredient in the type 2 diabetes drug Ozempic and the high-dose drug Wegovy. Since the FDA’s approval of Wegovy in 2021, Ozempic has often been prescribed off-label for weight loss. In large, placebo-controlled trials of Wegovy, people lost about 15% of their weight, more than the average weight loss seen with diet and exercise or with older drugs. of obesity.

The advent of semaglutide ushered in a new era in the treatment of obesity. And Novo Nordisk and its competitors are trying to develop the next generation of these drugs. While Wegovy is already a higher-dose formulation of semaglutide (the maximum prescribed dose is 2.4 milligrams, compared to the maximum one-milligram dose for Ozempic), the company is banking that the effectiveness of medicine has not yet reached its ceiling.

The STEP UP trial included three groups: People who were given a placebo, a 2.4 milligram dose of semaglutide in Wegovy, or a 7.2 milligram dose.

When looking at people who fully followed the drug schedule (one weekly injection under the skin), those on the 7.2 milligram dose lost an average of 20.7% of their body weight afterwards at 72 weeks, compared to 17.5% body weight loss for the 2.4 milligram group, and 2.4% body weight loss for the placebo group. And even when people who didn’t fully comply were included, the higher-dose version still outperformed the original (18.7% body weight lost vs. 15.6%).

Just as important, the higher-dose version of semaglutide appears to be generally safe and tolerable. In the trial, the 7.2 milligram group experienced side effects comparable to the lower dose group, according to Novo Nordisk. GLP-1 drugs are known to cause gastrointestinal symptoms such as diarrhea or vomiting, although these side effects are usually mild to moderate and tend to disappear over time. Very rarely, scientists have linked GLP-1 drugs to serious complications such as gastroparesis (stomach paralysis).

“The results from STEP UP further strengthen the clinical profile of semaglutide for the treatment of obesity, in addition to the health benefits already established with Wegovy,” said Martin Holst Lange, executive vice president for Development of Novo Nordisk, in a statement from the company.

The company will also soon release the results of the STEP UP T2D trial, which is testing the 7.2 milligram dose for people with obesity and type 2 diabetes. Assuming things go to plan, semaglutide is likely to have a long shelf life as a top-tier obesity and diabetes treatment for Novo Nordisk, even with other companies fast approaching. their own drug candidates down the road. But even the highest-dose version is expected to face stiff competition.

In a head-to-head trial exposed Late last year, Eli Lilly’s existing drug tirzepatide (the active ingredient in diabetes drug Mounjaro and obesity treatment Zepbound) outperformed Wegovy, with an average of 20.2% weight loss. in the body compared to 13.7%. Another obesity development drugs also showed early, but promising results that may overshadow tirzepatide and semaglutide.

Another consideration is cost. Current low-dose formulations of semaglutide have been around for several years at this point, and their high list price (about $1,000 per month) has angered both public and policymakers. This week, the federal government Office has partnered that it will schedule Ozempic and Wegovy for the next round of the recently debuted drug negotiation program under Medicare (any potential cuts won’t happen until 2027, however). While a higher dose of semaglutide would be more effective in treating obesity, it would also likely allow the company to continue selling its drug at the same or higher price than the current versions.

The future of obesity treatment looks bright, but it is also expensive.