Lilly's oral GLP-1, orforglipron, demonstrated superior glycemic control in two successful Phase 3 trials, reconfirming its potential as a foundational treatment in type 2 diabetes
In ACHIEVE-2, orforglipron lowered A1C by up to 1.7% compared to 0.8% with dapagliflozin, meeting the primary endpoint
In ACHIEVE-5, orforglipron lowered A1C by an additional 2.1% when taken with insulin glargine, meeting the primary endpoint
"Orforglipron has now demonstrated superiority over two active comparators in clinical trials for type 2 diabetes," said
ACHIEVE-2 and ACHIEVE-5 Results |
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ACHIEVE-2 Primary Endpoint |
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|
Orforglipron |
Orforglipron |
Orforglipron |
Dapagliflozin |
|
Change in |
Efficacy |
-1.3 % |
-1.7 % |
-1.7 % |
-0.8 % |
Treatment- |
-1.2 % |
-1.5 % |
-1.6 % |
-0.8 % |
|
ACHIEVE-5 Primary Endpoint |
|||||
|
Orforglipron |
Orforglipron |
Orforglipron |
Placebo |
|
Change in |
Efficacy |
-1.5 % |
-2.1 % |
-1.9 % |
-0.8 % |
Treatment- |
-1.6 % |
-1.9 % |
-1.8 % |
-0.8 % |
i All doses of orforglipron achieved statistical significance vs. the comparator, with p<0.001 under both the efficacy and treatment-regimen estimands. |
ii Insulin glargine doses were adjusted per a treat-to-target algorithm with no restriction from week four to week 40. |
In both trials, the overall safety and tolerability profile of orforglipron, as well as treatment discontinuation rates, were consistent with previous studies. The most common adverse events were gastrointestinal-related and generally mild-to-moderate in severity. No hepatic safety signal was observed.
The detailed results of these trials will be presented at a future medical meeting and published in a peer-reviewed journal. Results are expected in the first quarter of 2026 for ACHIEVE-4, the final global registration trial in the ACHIEVE program. Lilly plans to submit orforglipron for the treatment of type 2 diabetes to global regulatory agencies in 2026, while submission for the treatment of obesity is on track to occur by the end of this year.
About orforglipron
Orforglipron (or-for-
About ACHIEVE-2, ACHIEVE-5 and the ACHIEVE clinical trial program
ACHIEVE-2 (NCT06192108) is a Phase 3, 40-week, randomized, active-controlled, open-label study comparing the efficacy and safety of orforglipron 3 mg, 12 mg and 36 mg to dapagliflozin 10 mg in participants with type 2 diabetes and inadequate glycemic control with metformin. The study randomized 962 participants in a 1:1:1:1 ratio to receive either orforglipron 3 mg, 12 mg or 36 mg, or dapagliflozin 10 mg once daily, in addition to background metformin therapy. The objective of the study was to demonstrate that orforglipron is non-inferior in A1C reduction from baseline after 40 weeks, compared to dapagliflozin. Study participants had an A1C between ≥7.0% and ≤10.5% and a BMI of ≥23 kg/m2. Participants randomized to orforglipron initiated treatment with 1 mg once daily and increased the dose every four weeks until reaching the randomized dose of 3 mg, 12 mg or 36 mg.
ACHIEVE-5 (NCT06109311) is a Phase 3, 40-week, randomized, double-blind, placebo-controlled study assessing the efficacy and safety of orforglipron 3 mg, 12 mg and 36 mg in participants with type 2 diabetes and inadequate glycemic control with insulin glargine, with or without metformin and/or SGLT-2 inhibitors. The study randomized 546 participants in a 1:1:1:1 ratio to receive either orforglipron 3 mg, 12 mg or 36 mg, or placebo with background therapy of titrated insulin glargine alone or in combination with metformin and/or SGLT-2 inhibitors. The objective of the study was to demonstrate that orforglipron is superior in A1C reduction from baseline after 40 weeks, compared to placebo. Study participants had an A1C between ≥7.0% and ≤10.5% and a BMI of ≥23 kg/m2. Participants randomized to orforglipron initiated treatment with 1 mg once daily and increased the dose every four weeks until reaching the randomized dose of 3 mg, 12 mg or 36 mg.
The ACHIEVE Phase 3 global clinical development program for orforglipron has enrolled more than 6,000 people with type 2 diabetes across five global registration trials. The program began in 2023, and additional results are anticipated in early 2026.
Endnotes and References
- The efficacy estimand represents efficacy had all randomized participants remained on study intervention (with possible dose interruptions) without initiating additional antihyperglycemic medications (>14 days of use).
- The treatment-regimen estimand represents the estimated average treatment effect regardless of adherence to study intervention or initiation of additional antihyperglycemic medications.
- Body weight for orforglipron 3 mg vs. dapagliflozin 10 mg was not a primary or key secondary endpoint in ACHIEVE-2.
- Ma X, Liu R, Pratt EJ, Benson CT, Bhattachar SN, Sloop KW. Effect of Food Consumption on the Pharmacokinetics, Safety, and Tolerability of Once-Daily Orally Administered Orforglipron (LY3502970), a Non-peptide GLP-1 Receptor Agonist. Diabetes Ther. 2024 Apr;15(4):819-832. https://doi.org/10.1007/s13300-024-01554-1. Epub 2024 Feb 24. PMID: 38402332; PMCID: PMC10951152.
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T. Kawai ,B. Sun ,H. Yoshino ,D. Feng ,Y. Suzuki ,M. Fukazawa ,S. Nagao ,D.B. Wainscott ,A.D. Showalter ,B.A. Droz , T.S. Kobilka,M.P. Coghlan ,F.S. Willard , Y. Kawabe, B.K. Kobilka , &K.W. Sloop , Structural basis for GLP-1 receptor activation by LY3502970, an orally active nonpeptide agonist, Proc. Natl. Acad. Sci.U.S.A. 117 (47) 29959-29967, https://doi.org/10.1073/pnas.2014879117(2020).
About Lilly
Lilly is a medicine company turning science into healing to make life better for people around the world. We've been pioneering life-changing discoveries for nearly 150 years, and today our medicines help tens of millions of people across the globe. Harnessing the power of biotechnology, chemistry and genetic medicine, our scientists are urgently advancing new discoveries to solve some of the world's most significant health challenges: redefining diabetes care; treating obesity and curtailing its most devastating long-term effects; advancing the fight against Alzheimer's disease; providing solutions to some of the most debilitating immune system disorders; and transforming the most difficult-to-treat cancers into manageable diseases. With each step toward a healthier world, we're motivated by one thing: making life better for millions more people. That includes delivering innovative clinical trials that reflect the diversity of our world and working to ensure our medicines are accessible and affordable. To learn more, visit Lilly.com and Lilly.com/news, or follow us on Facebook, Instagram and LinkedIn. P-LLY
Cautionary Statement Regarding Forward-Looking Statements
This press release contains forward-looking statements (as that term is defined in the Private Securities Litigation Reform Act of 1995) about orforglipron as a potential treatment for adults with type 2 diabetes, Lilly's ability to supply orforglipron, if approved, and the timeline for future readouts, presentations, and other milestones relating to orforglipron and its clinical trials and reflects Lilly's current beliefs and expectations. However, as with any pharmaceutical product, there are substantial risks and uncertainties in the process of drug research, development, and commercialization. Among other things, there is no guarantee that planned or ongoing studies will be completed as planned, that future study results will be consistent with study results to date, that orforglipron will prove to be a safe and effective treatment for type 2 diabetes, that orforglipron will receive regulatory approval, or that Lilly will execute its strategy as expected. For further discussion of these and other risks and uncertainties that could cause actual results to differ from Lilly's expectations, see Lilly's Form 10-K and Form 10-Q filings with the
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