Amylin drugs have become the next big thing in obesity. Eli Lilly CEO David Ricks, understandably, thinks his rivals don’t have a chance for one key reason.
Eli Lilly CEO David Ricks has fired a shot across the bow to aspiring weight loss competitors like AbbVie and Pfizer with amylin assets under development. Lilly has “dialed out” a key hormone receptor in its molecule to drive better efficacy without side effects—something the rival companies have not done, according to Ricks.
The scientific tit-for-tat began Monday, when Ricks, appearing on a podcast with investment company Woodline Partners, said his company’s up-and-coming obesity drug eloralintide is better than its rivals because of a heavy bias for amylin. A Phase 2 trial showed that eloralintide is biased 12-1 for amylin and just 1 to calcitonin, which Ricks suggested drives higher weight loss.
This pathway has become the next big thing in the obesity pipeline. The amylin hormone is involved in satiation and control of food intake.
Eloralintide is a selective amylin receptor agonist, which differs from rival products, which are dual amylin and calcitonin receptor agonists (DACRA)—hitting two receptors.
“There’s a receptor in that family that they all hit that causes some GI that’s the calcitonin receptor. We pushed that out,” Ricks explained on the podcast. That way, the drug should avoid common gastrointestinal side effects and require less complex titration.
Lilly has already achieved 20% weight loss at 48 weeks with eloralintide in a Phase 2 clinical trial, results Ricks said will lead to the drug becoming a major product. The company is eyeing a combination approach with its blockbuster tirzepatide—marketed as Zepbound for weight loss and Mounjaro for diabetes—to boost weight loss. Eloralintide has now moved on to a registrational Phase 3 trial.
AbbVie’s executives were asked to respond to Rick’s dismissal of the dual amylin approach during a first quarter earnings call on Wednesday. The company’s weight loss work is still early days, with ABBV-295 in Phase 1 testing.
Chief Scientific Officer Roopal Thakker argued that the calcitonin receptor has benefits to bone health and that this could be a key asset to AbbVie’s approach
“That could be very important for women, especially as they get older. And we know with rapid weight loss, you do see loss of bone density,” Thakker said. “At this stage, we see this as a potential advantage because of the efficacy and tolerability that we’ve seen to date.”
The current trial mostly enrolls men with BMIs around 29, in which Thakker told analysts that ABBV-295 has shown “substantial” weight loss. AbbVie plans to conduct scans throughout testing to monitor for bone preservation. Future testing will include more woman, bringing the gender ratio closer to 50/50.
Besides AbbVie, companies such as Novo Nordisk, Pfizer and Structure Therapeutics are also developing DACRA molecules.
Amylin has not been an easy target. Another Big Pharma aspiring to tap into the obesity market, Roche, recently suffered a blow to its plans as the Zealand Pharma–partnered asset petrelintide achieved just 9% weight loss at 42 weeks in a Phase 2 trial. CEO Thomas Schinecker, however, stood by the asset on the company’s first quarter earnings call last week, insisting that the drug has a future as “it’s so tolerable.”
ABBV-295, meanwhile, elicited over 9% weight loss at 13 weeks in a Phase 1 trial.
