- GLP-1 medications, such as Ozempic and Wegovy, have skyrocketed in popularity and are used to treat type 2 diabetes and aid in weight loss.
- However, studies show they do not work for everyone, especially when it comes to weight loss.
- A new study found that a new type of medication, called eloralintide, which targets a different hormone called amylin, helped people achieve meaningful weight loss.
However, not everyone who takes a GLP-1 medication loses weight. Past studies show that as much as 17% of GLP-1 users may be “non-responders” to the medication.
“Obesity is a highly complex chronic medical condition,” Liana K. Billings, MD, MMSc, vice chair of research in the Department of Medicine, and director of clinical and genetics research in diabetes and cardiometabolic disease at Endeavor Health in Illinois, told Medical News Today.
“Because people respond differently to obesity medications, some may experience limited weight loss or may not tolerate current highly effective incretin-based therapies. For this reason, it is essential to continue developing additional treatments that target different biological pathways. Expanding the therapeutic toolbox allows clinicians to tailor therapy to each individual, ensuring that every person has the most effective and well-tolerated option for long-term weight management.”
— Liana K. Billings, MD, MMSc
Billings is the lead author of a Phase 2 clinical trial recently published in the journal The Lancet, reporting that people achieved meaningful weight loss through the use of a new weight loss medication that, instead of focusing on the hormone GLP-1, is a receptor agonist for a different hormone called amylin.
Eloralintide is the name of the new medication produced by Eli Lilly and Company that is focused on in this clinical trial. Like the GLP-1 medications already on the market, eloralintide is a subcutaneous injection created to be taken once a week.
According to Billings, amylin is a hormone that is secreted from cells in the pancreas when eating a meal.
“Eloralintide acts like amylin, because it is a selective amylin-agonist,” she continued. “Eloralintide acts in the brain to regulate appetite, slows gastric emptying, and helps metabolism. In this way, it can be an effective therapy for obesity.”
The Phase 2 clinical trial included 263 adults who had obesity or overweight, had at least one obesity-related comorbidity, and did not have type 2 diabetes. Participants were given different amounts of eloralintide or a placebo.
After 48 weeks, researchers found that all participants who received eloralintide experienced average weight loss between 9-20%, compared to only 0.4% weight loss in those on the placebo.
“The weight loss we saw in the study is clinically impactful. With this degree of weight loss in only 48 weeks, we see people having improvement or resolution in other conditions like hypertension, hyperlipidemia, osteoarthritis, sleep apnea, and more weight-related conditions,” Billings said.
“Furthermore, in the study, we did not see a nadir or plateau of weight loss, so I would expect weight loss to continue if the study continued for a longer duration. Additionally, up to 90% of participants on eloralintide improved by at least one BMI category,” she added.
“Obesity is a risk factor for a broad spectrum of diseases, including cardiovascular disease. A treatment that addresses not only obesity, but also improves lipid profiles, blood pressure, glycemic control and inflammation, could potentially reduce the risk of cardiovascular disease. Further studies are needed with eloralintide to examine the long term impact on cardiovascular disease risk.”
— Liana K. Billings, MD, MMSc
“The next steps involve launching Phase 3 clinical trials, which will study eloralintide in a much larger and more diverse group of participants to further examine eloralintide’s effectiveness and long-term safety,” she added. “These trials are critical because they provide the final data needed for regulatory review.”
MNT spoke with Jeffrey Kraft, MD, chief of general surgery, specializing in bariatric surgery, for Palisades Medical Center in New Jersey, about this study, who commented that his initial reaction to the results was one of measured optimism.
“The reported weight loss results are certainly noteworthy, nearly equal to the current GLP-1 agonist medications,” Kraft explained. “It may represent a significant step forward in pharmaceutical development. However, my experience in this field has taught me to view these early findings through a pragmatic lens. The journey from a promising early-phase study to a widely-used, trusted therapy is a long one.”
“The most important questions for me are always about long-term safety and the sustainability of the results,” he continued. “We need to see how patients fare over several years, not just several months, to truly understand the risk-benefit profile before we can determine its ultimate place in treatment.”
“Having medications like eloralintide, which work through a different mechanism, may provide a vital alternative and increase our ability to personalize treatment for the individual. A broader portfolio of drugs with different mechanisms of action is not about replacing what we have, but about expanding our options to help more patients successfully and safely manage their weight in the long term.”
— Jeffrey Kraft, MD
MNT also spoke with Mir Ali, MD, a board certified general surgeon, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, about this research.
Ali commented that he was excited to see a study that targets a different receptor, other than GLP-1, that can aid in weight loss.
GLP-1 vs. amylin
“Hunger, satiety, and weight management is controlled by a number of different hormones in the body, and the more we learn and discover new ways to help people manage their weight, the better. Sometimes people are more responsive to one hormone or another and having a variety of options available would allow a greater number of treatment options.”
— Mir Ali, MD
“The next step would be to compare the effectiveness of this new medication with ones already on the market and compare cost,” Ali added. “As many people know, these medications are very expensive and are often not covered by insurance. So, if there are more options that can be potentially cost-effective, that would benefit more people.”