Topline Phase 3 results of survodutide—licensed to Boehringer Ingelheim from Zealand Pharma—are more comparable to Novo Nordisk’s Wegovy than to Eli Lilly’s Zepbound, William Blair analysts said on Tuesday.
Boehringer Ingelheim and Zealand Pharma’s obesity candidate generated placebo-controlled weight loss of 13.4% after 76 weeks in a Phase 3 trial—topline results that failed to impress at least one analyst on Tuesday.
In the SYNCHRONIZE-1 trial, survodutide—a novel glucagon/GLP-1 dual agonist licensed to Boehringer by Zealand—an average of 39.2 lbs from baseline at the 76-week mark, a result Zealand calculated as 16.6% in its press release, versus 3.2% in the placebo arm. This result met both of the trial’s primary weight loss endpoints.
The data “appear less competitive vs other dual target mechanisms like Lilly’s tirzepatide,” BMO Capital Markets said in a note to investors Tuesday morning, in which analysts said the data “underwhelms.” Tirzepatide, marketed as Zepbound for weight management, led to 20.1% placebo-adjusted weight loss after 72 weeks in the SURMOUNT-1 trial, the firm noted.
William Blair, in its own note on Tuesday, said survodutide’s Phase 3 results are “more akin to Wegovy than Zepbound,” as 2.4 mg of Novo Nordisk’s injectable weight loss drug generated 14.4% weight loss.
Drilling down into the data, the analysts found more likenesses to Wegovy. In SYNCHRONIZE-1, 85% of trial participants on survodutide lost at least 5% of their body weight compared to 39% on placebo; this compares to 92% of patients taking Wegovy vs. 33% on placebo, according to William Blair. These numbers are for 96% vs. 28% for Zepbound, the firm said. Notably, there have been no trials directly comparing survodutide to either of these approved products.
Survodutide also met the SYNCHRONIZE-1 trial’s key secondary endpoint, leading to a statistically significant reduction in waist circumference—a clinical marker closely linked to visceral fat and cardiometabolic risk, according to Zealand—after 76 weeks vs. placebo.
Notably, weight reduction was driven mainly by fat loss, Zealand said Tuesday, with lean mass contributing “only a small proportion of total weight.”
BMO analysts also caught this commentary, writing: “It remains unclear what proportion of weight loss was specifically from fat loss, but a more selective weight loss profile could still be valuable as a therapy in the obesity space, pending how significant these differences in fat loss composition are.”
“There is an urgent need for new therapies that go beyond weight reduction alone to support meaningful improvements in metabolic health,” Carel le Roux, professor at University College in Dublin, Ireland, and SYNCHRONIZE-1’s global coordinating investigator, said in a statement. “Survodutide’s dual agonism is particularly exciting, as it offers a promising approach to addressing this significant unmet need in care.”
Nevertheless, today’s release was insufficient to set survodutide apart for analysts. “Overall, we do not believe there is any notable differentiation of survodutide compared with Wegovy or Zepbound based on today’s release,” William Blair said.
Survodutide’s potential differentiation could come from its from its liver-related benefit, the analysts added, noting that results of Boehringer’s Phase 3 SYNCHRONIZE-MASLD study, evaluating the drug in people with obesity or overweight who also have metabolic dysfunction-associated steatohepatitis, are due later this year.
As for safety, trial participants in SYNCHRONIZE-1 experienced “gastrointestinal events,” according to Zealand, with discontinuations happening more often in the dose-escalation phase. These events were mild-to-moderate in severity. This safety profile is “in line” with that of the broader GLP-1 class, BMO noted.
