Novo Nordisk's high-dose Wegovy (semaglutide) has demonstrated significant weight loss in a Phase III trial, offering a potential boost in efficacy for the popular obesity treatment. The STEP UP trial investigated a 7.2 mg dose of Wegovy, revealing a 20.7% reduction in body weight over 72 weeks. This compares favorably to the 17.5% weight loss observed with the currently approved 2.4 mg dose. The trial, which involved 1,407 adults with obesity but without diabetes, also showed that one-third of patients on the higher dose lost at least 25% of their body weight, versus 16.7% on the lower dose.
Efficacy and Tolerability
According to Novo Nordisk, the 7.2 mg dose exhibited a safe and well-tolerated profile, aligning with other GLP-1 drugs. The most common adverse events were gastrointestinal, but the vast majority were mild to moderate and diminished over time. These findings suggest that increasing the dose could enhance the weight loss experienced by individuals on Wegovy without significantly compromising safety.
Market Competition
Despite the promising results, Wegovy faces stiff competition from Eli Lilly's Zepbound (tirzepatide). In a head-to-head Phase IIIb trial, Zepbound demonstrated a 20.2% weight loss over 72 weeks. While cross-trial comparisons should be interpreted cautiously, these results suggest that Zepbound may have a slight edge over Wegovy in terms of efficacy. Leerink Partners analysts noted that the Wegovy results give them greater confidence in the long-term market share of tirzepatide.
Future Directions
Novo Nordisk is also exploring the potential of combining semaglutide with other therapies, such as CagriSema. The 7.2 mg data could enable Novo to pursue even higher doses with CagriSema. Results from a second late-stage trial testing a 7.2mg dose of Wegovy in adults with type 2 diabetes and obesity are expected within the next few months.
