The second quarter of 2025 delivered significant regulatory milestones in endocrinology, with the FDA accepting Novo Nordisk's groundbreaking application for oral semaglutide 25 mg for weight management and approving several other innovative treatments that promise to transform patient care across multiple endocrine disorders.
Oral GLP-1 Breakthrough for Obesity Treatment
On May 2, 2025, Novo Nordisk announced the FDA accepted its New Drug Application for a once-daily 25 mg oral formulation of semaglutide for chronic weight management in adults with obesity or overweight and at least one comorbidity. Based on results from the 64-week OASIS 4 trial, the oral semaglutide demonstrated significant weight loss and cardiovascular risk reduction.
According to Novo Nordisk, this could become the first oral GLP-1 therapy approved for obesity, expanding individualized treatment options beyond injectable formulations. An FDA decision is expected in Q4 2025.
CGM Technology Reaches New Milestone
The FDA cleared Dexcom's G7 15-day continuous glucose monitoring system for adults with diabetes on April 10, 2025, establishing it as the longest-lasting and most accurate CGM approved in the United States. Based on clinical data showing a mean absolute relative difference (MARD) of 8.0%, the G7 15 Day demonstrated excellent accuracy and user satisfaction.
According to Dexcom, the system offers features like Apple Watch integration, waterproof sensors, and extended wear with a 12-hour grace period for sensor changes. The company plans to ensure compatibility with insulin pump systems ahead of its US launch in late 2025.
Expanded Treatment Options for Cushing's Syndrome
On April 16, 2025, the FDA approved Recordati's supplemental New Drug Application for osilodrostat (Isturisa), expanding its indication to include adults with endogenous Cushing's syndrome who are not surgical candidates or for whom surgery was not curative. Previously approved only for Cushing's disease, the broader label is supported by data from the LINC 3 and LINC 4 trials showing sustained cortisol reduction and clinical improvement.
According to Recordati, osilodrostat offers a vital option for managing hypercortisolemia and preventing severe complications.
Pediatric Adrenal Insufficiency Treatment Advances
The FDA approved Eton Pharmaceuticals' hydrocortisone oral solution (KHINDIVI) for pediatric patients aged 5 and older with adrenocortical insufficiency on May 28, 2025, marking the first liquid formulation approved for this use. Designed for accurate, individualized dosing, the 1 mg/mL solution helps patients who have difficulty swallowing pills.
According to Eton, this ready-to-use formulation eliminates the need for pill-splitting and supports improved treatment outcomes during childhood development.
Clinical Trial Developments
The quarter also featured significant clinical trial data, including results from the SURPASS-SWITCH trial showing that switching to tirzepatide from escalating dulaglutide was linked to greater reduction in hemoglobin A1c and weight loss among individuals with inadequately controlled type 2 diabetes and obesity.
Additionally, Eli Lilly's oral orforglipron demonstrated effectiveness and safety for adults with type 2 diabetes inadequately controlled by diet and exercise in the Phase 3 ACHIEVE-1 trial, achieving statistically significant reductions in HbA1c and body weight.
ADA Scientific Sessions Highlights
June's American Diabetes Association Scientific Sessions in Chicago capped the quarter with a surge of new data on incretin therapies, obesity drugs, and diabetes technology. The meeting featured multiple sessions dedicated to late-breaking research, including studies on semaglutide for MASH treatment and the REDEFINE trials evaluating CagriSema for substantial weight loss and glycemic improvements.
These developments collectively signal a shift toward more personalized, effective endocrine care, with expanded treatment options addressing unmet medical needs across diabetes, obesity, and rare endocrine disorders.
