Lilly's oral GLP-1, orforglipron, showed compelling efficacy and a safety profile consistent with injectable GLP-1 medicines, in complete Phase 3 results published in The New England Journal of Medicine
The investigational once-daily pill lowered A1C by an average of 1.3% to 1.6% across doses, with improvements seen as early as four weeks, in adults with type 2 diabetes
In ACHIEVE-1, orforglipron also led to an average weight loss of 16.0 lbs (7.9%) at the highest dose by week 40 in a key secondary endpoint
The safety profile of orforglipron was consistent with the established GLP-1 class
In the study, orforglipron met the primary endpoint of superior A1C reduction compared to placebo at 40 weeks, lowering A1C by 1.3% to 1.6% from a baseline of 8.0%, for the efficacy estimand.1 In key secondary endpoints, up to 76.2% of participants taking orforglipron achieved the
"The ACHIEVE-1 trial demonstrated that orforglipron, a novel oral small-molecule GLP-1, achieved clinically meaningful reductions in A1C and body weight over 40 weeks in adults with type 2 diabetes," said Dr.
Full Results |
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|
Orforglipron 3 mg |
Orforglipron 12 mg |
Orforglipron 36 mg |
Placebo
|
|
Primary Endpoint |
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A1C reduction from baseline of 8.0 %i |
Efficacy estimand |
1.3 % |
1.6 % |
1.5 % |
0.1 % |
Treatment-regimen estimand4 |
1.2 % |
1.5 % |
1.5 % |
0.4 % |
|
Key Secondary Endpoints ii |
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Percent weight reduction from baseline of 90.2 kg (198.9 lbs)i,iii |
Efficacy estimand |
4.7 % |
6.1 % |
7.9 % |
1.6 % |
Treatment-regimen estimand |
4.5 % |
5.8 % |
7.6 % |
1.7 % |
|
Weight reduction from baseline of 90.2 kg (198.9 lbs)i,iii |
Efficacy estimand |
4.4 kg |
5.5 kg |
7.3 kg |
1.3 kg (2.9 lbs) |
Treatment-regimen |
4.2 kg (9.3 lbs) |
5.2 kg (11.5 lbs) |
7.2 kg (15.8 lbs) |
1.5 kg (3.4 lbs) |
|
Percent of participants achieving A1C <7 %i |
Efficacy estimand |
72.9 % |
76.2 % |
74.9 % |
28.0 % |
Treatment-regimen estimand |
68.1 % |
72.9 % |
72.7 % |
33.0 % |
|
Percent of participants achieving A1C ≤6.5 %i,ii |
Efficacy estimand |
61.5 % |
62.3 % |
66.0 % |
13.5 % |
Treatment-regimen |
56.9 % |
58.1 % |
61.9 % |
14.9 % |
|
Percent of participants |
Efficacy estimand |
17.7 % |
25.8 % |
23.9 % |
3.8 % |
Treatment-regimen estimand |
16.8 % |
23.9 % |
21.5 % |
3.8 % |
|
Fasting serum glucose of 147.5 mg/dLi |
Efficacy estimand |
30.6 mg/dL |
37.4 mg/dL |
37.8 mg/dL |
1.1 mg/dL |
Treatment-regimen estimand |
30.7 mg/dL |
36.5 mg/dL |
34.7 mg/dL |
10.8 mg/dL |
i
Superiority test was adjusted for multiplicity.
ii
Data from the full list of key secondary endpoints are available in the publication.
iii
Percent of participants achieving A1C <5.7% across all orforglipron doses and body weight for orforglipron 3 mg were not controlled for Type 1 error.
"This convenient once-daily pill with no restrictions on food and water intake could be an option for millions of people with type 2 diabetes who prefer oral medications over injectables," said
The overall safety profile of orforglipron in ACHIEVE-1 was consistent with the established GLP-1 class. The most common adverse events for participants treated with orforglipron (3 mg, 12 mg and 36 mg, respectively) were diarrhea (19%, 21% and 26%) vs. 9% with placebo, nausea (13%, 18% and 16%) vs. 2% with placebo, dyspepsia (11%, 20% and 15%) vs. 7% with placebo, constipation (8%, 17% and 14%) vs. 4% with placebo, and vomiting (5%, 7% and 14%) vs. 1% with placebo. These gastrointestinal-related adverse events were generally mild-to-moderate in severity and occurred primarily during dose escalation. Overall treatment discontinuation rates due to adverse events were 6% (3 mg), 4% (12 mg) and 8% (36 mg) for orforglipron vs. 1% with placebo. No hepatic safety signal was observed.
Later this year, Lilly expects to share topline results from ACHIEVE-2, evaluating orforglipron compared with dapagliflozin, and ACHIEVE-3, evaluating orforglipron compared to oral semaglutide, both in adults with type 2 diabetes inadequately controlled with metformin. ATTAIN-1 and ATTAIN-2, evaluating orforglipron for weight management, will also be shared in the third quarter of this year. Lilly remains on track to submit orforglipron for weight management to global regulatory agencies by the end of this year and for the treatment of type 2 diabetes in 2026.
About orforglipron
Orforglipron (or-for-
About ACHIEVE-1 and the ACHIEVE clinical trial program
ACHIEVE-1 (NCT05971940) is a Phase 3, 40-week, randomized, double-blind, placebo-controlled trial comparing the efficacy and safety of orforglipron 3 mg, 12 mg and 36 mg as monotherapy to placebo in adults with type 2 diabetes and inadequate glycemic control with diet and exercise alone. The trial randomized 559 participants across the
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 with results anticipated later this year and into 2026.
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
- The efficacy estimand represents the treatment effect had on all participants who adhered to the study drug (with possible dose interruptions) for 40 weeks without initiating additional antihyperglycemic medications (>14 days of use).
-
American Diabetes Association . Standards of Care in Diabetes—2020 Abridged forPrimary Care Providers . Clinical Diabetes 2020; 38(1):10–38. https://doi.org/10.2337/cd20-as01 - Percent of participants achieving A1C <5.7% across all doses was not controlled for Type 1 error.
- The treatment-regimen estimand represents the estimated average treatment effect regardless of treatment discontinuation or initiation of additional antihyperglycemic medications.
- 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).
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, 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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Refer to: |
Brooke Frost; brooke.frost@lilly.com; 317-432-9145 (Media) |
|
Michael Czapar; czapar_michael_c@lilly.com; 317-617-0983 (Investors) |
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