Eloralintide, an experimental obesity drug, has helped some adults lose nearly 50 pounds
A new type of injected weight loss drug is entering late-stage clinical trials, and it works differently from GLP-1 drugs like Ozempic, Wegovy, Mounjaro and Zepbound.
Based on these results, the company announced plans to start late-stage clinical trials next month.
How is Elorallintide different?
The popular injectable medications semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) target the gut hormone GLP-1 (glucagon-like peptide-1) and facilitate weight loss by reducing appetite and slowing digestion. Eloralintide belongs to a different family of drugs that work by mimicking the pancreatic hormone amylin to slow digestion and reduce hunger.
“Given the high rates of obesity and diabetes, additional treatment options are welcome,” says Marilyn Tan, MD, clinical professor of endocrinology at Stanford University School of Medicine and chief of the Endocrine Clinic at Stanford Health Care in California.
An existing amylin-mimicking drug, pramlintide (Symlin), has been available in the United States for years as a treatment for diabetes, Dr Tan says. But it hasn’t been used much because it requires injections three times a day with meals.
People receiving the highest dose lost almost 50 pounds
In a mid-term clinical trial, researchers randomly assigned 263 obese but non-diabetic adults to receive weekly injections of eloralintide or a placebo for 48 weeks. At the start of the study, participants weighed on average about 240 pounds (lb).
At the end of the study, people taking the lowest dose of eloralintide lost 9.5 percent of their body weight on average, or about 23 pounds. People taking the highest dose lost about 20 percent, or about 47 pounds, according to results reported by Eli Lilly.
People taking eloralintide also saw improvements in other risk factors for obesity-related health problems, according to Lilly, including:
- Waistline
- Blood pressure
- Blood sugar
- Inflammation
The most common side effects of eloralintide were mild to moderate gastrointestinal problems and fatigue, which occurred more often with higher doses of the drug, according to the company. Gradually increasing the dose of the drug helped minimize side effects, the company also said.
So far, weight loss results with eloralintide are not as dramatic as those patients can achieve with bariatric surgery, but appear consistent with those of other obesity medications, says Melanie Jay, MD, professor of population health at New York University Langone Health in New York and director of the NYU Langone Obesity Research Program.
“We don’t have long-term data on this particular drug, but the rate of weight loss appears to be similar to tirzepatide,” says Dr. Jay.
Rapid weight loss can lead to muscle loss
Obesity doctors are concerned that rapid weight loss such as that caused by eloralintide could cause problems. “The question of whether weight loss can be maintained over time is complex and often depends on whether patients continue to take the medications that helped them lose the initial weight,” says Tan. “With rapid weight loss, there is also concern about loss of lean muscle mass. »
It doesn’t happen to everyone, and there isn’t yet enough research to determine which people are most at risk of losing muscle when taking weight-loss medications, Jay says. For this reason, it’s important that people do exercises designed to build muscle while they’re taking GLP-1 medications or amylin medications like eloralintide, advises Jay.
“We need to make sure people are doing resistance training, which we hope will prevent excessive muscle loss,” says Jay.
Amylin vs GLP-1 drugs for weight loss
Because eloralintide is still an experimental drug that has not yet been tested in advanced human trials, it’s really too early to say for sure whether it’s safer or more effective than GLP-1 drugs, Jay says.
Uncomfortable stomach side effects have been observed with GLP-1 drugs and with the eloralintide data published so far, Tan notes. This makes it possible that side effects could lead some patients to discontinue treatment, whether they are taking a GLP-1 or an amylin drug, Tan says.
“Cost and tolerability are common reasons why patients stop GLP-1 agonists or cannot even start them,” says Tan. Similar problems are likely with an amylin drug like eloralintide, Tan adds, noting that new drugs also tend to be expensive.
Still, competition and new treatment options should benefit obese patients, Jay says. “It would be great one day to be able to figure out which medications are most effective for different people so we can help them decide which medications to start,” Jay says.
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