In the last four years, the obesity drug industry has seen a significant transformation, with GLP-1 agonists moving into the spotlight for their efficacy in obesity and now, their potential heart health benefits. The FDA's approval of Novo Nordisk’s Wegovy (semaglutide) for reducing cardiovascular risk in adults with cardiovascular disease and obesity or overweight marks a pivotal moment. This decision was based on the Phase III SELECT trial, which demonstrated a 20% reduction in major adverse cardiovascular events compared to placebo.
An AI proof-of-concept study by Dandelion Health expanded on these findings, suggesting that GLP-1 use could also benefit those without severe preexisting cardiovascular disease, reducing their risk scores for major adverse cardiac events by 15% to 20% after three years of treatment. This indicates that GLP-1s may serve as primary prevention against cardiovascular disease for an additional 44 million at-risk patients in the U.S.
Despite the focus on diabetes and obesity, the accumulating evidence of GLP-1s' benefits in cardiac outcomes is prompting more companies to explore these indications. The first-in-human trials studying GLP-1s' effects on cardiovascular outcomes date back to 2016, with consistent benefits observed across multiple trials. The mechanism behind these benefits, whether due to weight loss, blood sugar control, or other actions of GLP-1 agonists, remains a topic of research.
Novo Nordisk and Lilly are among the companies conducting further studies to evaluate GLP-1s' efficacy in cardiovascular indications, with ongoing trials exploring their impact on patients with type 2 diabetes and atherosclerotic cardiovascular disease, as well as their potential to reduce obesity-related diseases and death.
As the obesity drug market is forecasted to reach $200 billion by 2031, the interest in GLP-1s continues to grow, with companies like Amgen and Structure Therapeutics advancing their candidates through clinical trials. The broad value of GLP-1s, beyond weight loss and side effects, is increasingly recognized, with ongoing research exploring their potential benefits in various conditions, including type 1 diabetes, kidney disease, and Alzheimer’s.
With over 400 active trials involving GLP-1 intervention, the future of this drug class looks promising, with 2025 anticipated to be a pivotal year for small molecules, particularly GLP-1s, as they expand into oral formulations and new therapeutic areas.
