In the incredibly hot obesity drug space, with more than 700 clinical trials ongoing, Verdiva Bio and MitoRx leaders discuss how next-generation therapies are targeting lean muscle preservation, extended efficacy and better safety profiles to enable lifelong weight management.
The market success of the next generation of obesity drugs hinge on critical differentiators, including sustainable weight loss that spares muscle mass, a better side-effect profile and adherence improvement.
The incredible traction of the GLP-1 market in the diabetes and now the obesity market, with a $1 trillion market opportunity, have stimulated both large pharma and biotechs to engage in obesity drug development.
There are more than 700 obesity clinical trials ongoing, noted Jane Hughes, president of R&D and co-founder of Verdiva Bio.
Current Obesity Therapy Paradigm
Although GLP-1s have demonstrated remarkable effects of short-term weight loss, they have shortfalls. They cause lean muscle loss, creating a “metabolic trap” with reduced basal metabolic rate that drives weight regain and limit long-term success, said Jonathan Rees, CEO and co-founder of MitoRx Therapeutics.
Hughes agreed, adding that GLP1-s face tolerability issues, with only 32% of patients continuing treatment after one year, leading to weight regain. Side effects include high rates of nausea, vomiting and diarrhea.
In terms of route of administration, GLP-1s for obesity have been administered subcutaneously until the December 2025 approval of Novo Nordisk’s oral Wegovy. As BioSpace has reported, the oral version has made GLP-1 medicines more accessible to many patients who had avoided injectable versions.
Multiple Drug Strategies
Ultimately, the goal for Verdiva Bio is to refine GLP-1s via convenience, tolerability, muscle preservation, combinations and lifelong weight management, Hughes said. The next generation of therapies supports a combination of modulation and appetite control, Rees said. Hughes concurred, adding obesity is more than just appetite. Long-term success is going to depend on metabolic efficiency, body composition and energy balance, she added.
Verdiva is developing once-weekly oral GLP-1 (VRB-101) and amylin (VRB-103) peptides as monotherapies, as well as daily or weekly combinations. MitoRx, which expects to present data at the American Diabetes Association 2026 conference in June, is developing subcutaneous and oral monotherapy options, with combination potential.
Both noted there is no one-size-fits-all approach for maintenance obesity treatment. The future will be a mix-and-match strategy, with switching therapies and combinations tailored to patient needs, Hughes said. Some patients may prefer to maintain the injectable approach they are accustomed to, Rees noted. Oral therapies are ideal for their convenience and lack of administration, Hughes added. In addition, they are easier than injectables in terms of shipping logistics, without the requirement of refrigeration.
The recent introduction of direct-to-consumer (DTC) obesity medication availability has both pros and cons, they agreed. The DTC market is key for U.S. traction and an overall therapeutic strategy, Hughes said. On the flip side, there is a concern that under-regulated DTC organizations that have capitalized on the market interest could lead to patient injuries.
