The Battle for Semaglutide's Successors: Emerging Contenders in the Obesity Treatment Market

In the highly competitive field of obesity treatment, a fierce competition is underway between Semaglutide and Tirzepatide. As these established players continue to dominate, a new wave of contenders has emerged, signaling the beginning of a Best-in-Class (BIC) race. This article explores the potential candidates vying for the title of BIC in obesity treatment, with a focus on Novo Nordisk's amycretin and Viking Therapeutics' VK2735.

As the pioneer of the daily oral formulation amycretin, Novo Nordisk's CEO, Lars Fruergaard Jørgensen, recently expressed optimism about its potential as a BIC for obesity treatment. Amycretin, a dual agonist of GLP-1 and amylin receptors, demonstrated impressive weight loss results of 13.1% over 12 weeks, surpassing the 6% reduction achieved by Wegovy during the same period. Although the molecular structure of amycretin remains undisclosed, its usage of the permeation enhancer SNAC suggests a peptide-based compound. Novo Nordisk plans to advance amycretin to Phase II studies in the second half of this year, with results expected by early 2026 and hopes to bring it to the market before 2030.

Coinciding with Novo Nordisk's amycretin Phase I results, Viking Therapeutics announced the clinical outcomes of their oral candidate VK2735. In a small-scale trial, patients receiving the highest dose experienced a 5.3% weight reduction after 28 days, with over 57% of patients achieving at least a 5% weight loss. VK2735 demonstrated an average weight loss of 13.1% after 13 weeks, surpassing the performance of Tirzepatide, a GLP-1/GIP dual receptor agonist, during the same period. Leerink Partners analysts noted that these results support VK2735's potential as a BIC.

While both amycretin and VK2735 have emerged as potential BICs, it is important to clarify that the concept of BIC here may not strictly adhere to the traditional definition. Typically, BIC drugs refer to those that outperform first-in-class (FIC) and next-in-class drugs within the same mechanism of action. Amycretin, being a dual agonist of GLP-1 and amylin receptors, and VK2735, a GLP-1/GIP dual receptor agonist, do not strictly fall under the same class. However, they possess the potential to become BICs in the absence of formally crowned contenders. The intense competition for BIC status is evident, particularly in the race to develop assets targeting popular receptors such as PD(L)1.

Commercial success in the pharmaceutical industry can be achieved through both FIC and BIC drugs. Studies analyzing the performance of 104 products launched after 2010 with new mechanisms of action revealed that FICs often perform better when launched earlier. The sales of the second wave of BIC drugs, which are both FICs and BICs, accounted for only 38% of the sales of the first wave of BIC drugs. However, even relatively low-performing FICs managed to capture 54% of the sales of products classified as both FICs and BICs. These findings suggest a correlation between FICs and commercial success, with some variations observed in different therapeutic areas.

As the battle for Semaglutide's successors heats up, Novo Nordisk's amycretin and Viking Therapeutics' VK2735 have emerged as potential contenders for the title of Best-in-Class in obesity treatment. While the exact classification of these candidates may vary, their impressive weight loss results and novel mechanisms of action position them as promising options in the quest for effective and innovative obesity treatments. The ultimate commercial success of these drugs will be determined by various factors, including their efficacy, safety, patient compliance, and cost-effectiveness.