Ecnoglutide

Eli Lilly’s plan is to submit retatrutide to regulators before the end of the year as a treatment for obesity, with a diabetes filing to follow in 2027.\n With the obesity numbers for Eli Lilly’s retatrutide already stacking up nicely, the company has rounded out its pitch for the triple agonist with top-line data on its ability to lower blood sugar levels and reduce weight in patients with Type 2 diabetes.The headline results, which Lilly reported Thursday, appear competitive with the GLP-1 drugs already on the market for diabetes.After 40 weeks of treatment, 4-mg, 9-mg and 12-mg doses of retatrutide—an agonist of GLP-1, GIP and a third hormone, glucagon, aka triple G—demonstrated average reductions in A1C of 1.7%, 1.9% and 1.9%, respectively, when accounting for all patients in the trial. These results hit the study\'s primary endpoint, the company said in a March 19 press release. When it came to the key secondary endpoint of weight loss, participants on the 12-mg dose of retatrutide lost an average of 36.6 pounds, or 16.8% of their body weight, when only assessing patients who received treatment as intended—known as an efficacy estimand. When stretching out the analysis to cover all patients who started on the 12-mg regimen, the average weight loss was reduced slightly to 15.3% (33.3 pounds).No plateauing of weight loss was identified by the 40-week mark, according to Lilly.The retatrutide weight loss figures fell short of the 25% or greater threshold investors had been hoping for, but that miss shouldn’t come as a surprise “given the shorter study time and T2D patient set,” analysts at Citi wrote in a note to clients Thursday.With the caveat that cross-trial comparisons are an imperfect tool, Novo in February reported that Type 2 diabetes patients who received CagriSema—a combination of Wegovy\'s ingredient semaglutide and experimental amylin receptor agonist cagrilintide—charted average efficacy estimand weight loss of 14.2% after 68 weeks. On A1C, CagriSema reduced patients’ blood sugar by 1.9% on average.When asked by Fierce Biotech how Lilly sees retatrutide lining up against the growing list of obesity competitors, a spokesperson for the Big Pharma pointed out there have “been no head-to-head studies to-date comparing retatrutide with other incretins, and it is not appropriate to draw conclusions from cross-trial comparisons due to differences in study designs and patient populations.” Back in December, 12 mg retatrutide was linked to an efficacy estimand weight loss of 28.7%—and a 75.8% reduction in pain scores—in a phase 3 trial of the triple agonist in patients with both obesity and knee osteoarthritis. While the weight loss in this morning\'s diabetes trial is noticeably lower than in the December phase 3 study, Lilly\'s spokesperson explained that losing weight is often harder for this patient population due to underlying metabolic factors.  Lilly’s Type 2 diabetes study for retatrutide enrolled 537 participants. Apart from the A1C and weight loss endpoints, the Transcend-T2D-1 trial also looked at measures like change from baseline in triglycerides, fasting serum glucose, non-HDL cholesterol and systolic blood pressure, as well as the specific thresholds of patients who achieved certain A1C reductions and weight loss levels.The plan is to submit retatrutide to regulators before the end of the year as a treatment for obesity, with a diabetes filing to follow in 2027, a spokesperson told Fierce.Lilly is counting on next-generation incretin medicines like retatrutide—as well as its oral GLP-1 orforglipron—to eventually pick up the torch from its current diabetes and obesity mainstays Mounjaro and Zepbound, both of which are underpinned by Lilly’s dual GIP/GLP-1 receptor agonist tirzepatide. “For many people with type 2 diabetes, it is a struggle to achieve both A1C control and weight loss, since obesity has historically been harder to treat for those with type 2 diabetes,” Kenneth Custer, Ph.D., president of Lilly Cardiometabolic Health, said in the release. “With triple agonist retatrutide, we set out to make a molecule that could help patients achieve substantial A1C reduction and weight loss,” Custer added. “These results support the remarkable potential of this novel molecule for people living with type 2 diabetes, with up to 2% A1C improvement and nearly 17% weight loss in 40 weeks of treatment.”Retatrutide may have exceeded predictions with its obesity data back in December, but that blowout efficacy was offset by a higher discontinuation rate, 18.2%, than expected by analysts. It was a better story this morning, with discontinuation rates from adverse events at the 12-mg dose at 5.1%. At this dose, the most common adverse events were nausea (26.5%), diarrhea (22.8%) and vomiting (17.6%), according to this morning\'s release, all common side effects from these types of medicines. While about 21% of patients in the 12-mg cohort of December\'s obesity trial experienced dysesthesia—an unpleasant feeling on the skin—this level was down to 4.4% in today\'s diabetes study.When taking this safety data into account, Citi analysts said they \"provide additional confidence in retatrutide’s additional applicability in high BMI (>35) patients as the market inevitably fragments.”Lilly’s new retatrutide data also appeared to stand up against the A1C reductions and weight loss charted by the current crop of approved GLP-1s for diabetes.  In the data included in Ozempic’s FDA-approved label, the drug at the 1-mg dose helped patients reduce their A1C by 1.6% from a baseline of 8.1% at 30 weeks and enabled them to lose an average of 4.7 kilograms (a little more than 10 pounds).Mounjaro’s FDA label clocks an average A1C reduction of 1.8% from baseline after 40 weeks. Patients on the drug lost between 6.3 and 7.8 kilograms, or between 14 and 17 pounds, according to the label. Elsewhere, a new commercial GLP-1 challenger has emerged in China by way of Pfizer and its local partner Sciwind Biosciences, which recently scored approval for their drug ecnoglutide under the respective diabetes and obesity brand names Xianyida and Xianweiying.Phase 3 data on ecnoglutide point to 2.2% to 2.6% A1C reductions at the highest, 1.2-mg, dose tested, versus 0.6% to 1.09% reductions on placebo, plus an average weight reduction of 3.21 kilograms (about seven pounds) at that dose. Editor\'s note: This story was updated at 8:15am ET on March 19 with details from an analyst note.

iStock, Anant_Kasetsinsombut While Johnson & Johnson retains the top revenue rank across the major pharma companies, Eli Lilly last year established itself as the clear leader in the obesity market, in the process capturing investors’ attention and enthusiasm. 2025 was Lilly’s year. While the company wasn’t able to topple any record-holders—Merck’s Keytruda technically remains the top selling drug and Johnson & Johnson holds the overall sales crown—the giant from Indiana has been the year’s biggest buzz-maker. In November, Lilly became the first pharma company to enter the trillion-dollar club , joining the tech-dominated pantheon of companies such as NVIDIA, Apple, Microsoft and Alphabet with a market cap over $1 trillion. Pharma’s second-largest company is J&J, which as of writing has a market cap of $585 billion—far behind Lilly. J&J does more than just pharma, with a robust medtech section that contributes heavily to earnings. While Lilly has consistently been a strong performer, its rise in 2025 was no doubt driven by strong execution in the cardiometabolic space, particularly for the obesity and diabetes drug tirzepatide. In a recent interview, CEO David Ricks claimed that Lilly captures 70% to 75% of new patients starting their GLP-1 journeys—“almost three-to-one” versus its main competitor Novo Nordisk. That’s not to say other pharmas didn’t have a strong 2025. J&J and Pfizer stand out, for instance, for keeping earnings afloat despite persistent headwinds—be it an impending patent cliff, a continued post-pandemic slide or the antagonistic rhetoric of a high-ranking health official. Others, still, have chosen to focus their efforts on building out their pipelines, paving the path for sustainable growth into the future. Here, BioSpace reviews the top five pharma companies in terms of revenue, looking at what’s behind their strong market performance in 2025 and how they plan to maintain their momentum moving forward. J&J Keeps Crown Despite Stelara Loss of Exclusivity 2025 Revenue: $94.19 billion YoY Growth: 6% With money flowing in from both the pharma and medtech industries, Johnson & Johnson is consistently among the top-earning drugmakers—and 2025 was no different. With $94.19 billion in sales , J&J holds a comfortable lead over its Big Pharma peers (Roche is the closest challenger, more than $10 billion behind), despite the biosimilar erosion that immunology blockbuster Stelara endured in 2025. The product lost key market protections early last year and saw sales nosedive 41% from 2024. J&J was well-prepared , however. In recent years, the pharma started cutting back on spending in some areas, such as infectious diseases and vaccines , and diverted these resources into immunology. The result is that newer products, including Tremfya and Simponi, have helped soften the blow of the Stelara cliff. Last year, these drugs surged nearly 40% and 22% year-on-year, respectively. Meanwhile, J&J’s cancer division continues to be the cornerstone of the pharma’s business. In 2025, oncology accounted for more than a quarter of the company’s revenue, bringing in $25.4 billion—almost 21% growth from the previous year. The myeloma drug Darzalex was the pharma’s top-selling product last year, with $14.35 billion in earnings. Medtech contributed $33.8 billion to J&J’s topline in 2025. Patents How J&J Kept Growing Amid the Erosion of Cornerstone Drug Stelara The company cut back in areas while investing in internal and external opportunities to offset the loss of exclusivity on a product that until recently accounted for 20% of innovative medicine sales. October 22, 2025 · 5 min read · Nick Paul Taylor Read more Roche Maintains Second-Place as Dealmaking Ramps Up 2025 Revenue: $79.48 billion YoY Growth: 7% Also racking up revenue from two industries—pharma and diagnostics—is Roche, which kept its second-place spot from the 2024 ranking. The group brought in CHF 61.516 billion ($79.48 billion) last year, representing 7% year-on-year growth. Ocrevus, a monoclonal antibody indicated for multiple sclerosis, continued to be Roche’s top-selling product, making CHF 7.01 billion ($9 billion) in 2025, a 9% increase. The hemophilia A therapy Hemlibra likewise had a strong year, growing 11% to hit CHF 4.754 billion ($6.12 billion) in sales. Beyond these products, Roche attributed its revenue growth to the asthma drug Xolair, which surged 32% year-on-year to hit sales of CHF 3.075 billion ($4.78 billion). Beyond its commercial performance, 2025 turned out to be a big dealmaking year for Roche. In September, the group acquired 89bio for $3.5 billion , obtaining its late-stage FGF21 analog pegozafermin for the treatment of metabolic dysfunction-associated steatohepatitis. Roche in March 2025 also dropped $1.65 billion upfront —and promised up to $3.6 billion more in milestones—to partner with Zealand Pharma on its long-acting amylin analog petrelintide for obesity. In October that year, during the pharma’s third quarter earnings call, CEO Thomas Schinecker said that despite these hefty investments, Roche “ is not done with BD .” The company has made good on that promise, with hundreds of millions poured into back -to- back cancer deals, as well as an RNA interference alliance . Earnings ‘We’re Not Done’: Roche Plans To Sustain Dealmaking Pace After 89bio Roche has already signed several high-ticket deals this year, including the $3.5 billion acquisition of 89bio and Genentech’s $2.1 billion molecular glue pact with Orionis Biosciences. October 23, 2025 · 2 min read · Tristan Manalac Read more Eli Lilly Skyrockets To Third on Back of Obesity Rush 2025 Revenue: $65.179 billion YoY Growth: 45% With a 45% increase in revenue from the year prior, Eli Lilly is by far 2025’s fastest-growing pharma, jumping six spots to land in third place on this list. The Indianapolis powerhouse’s 2025 sales hit $65.18 billion . Behind the company’s blockbuster year is the tirzepatide franchise. The drug, a dual agonist of the GLP-1 and GIP receptors, is marketed as Mounjaro for type 1 diabetes and Zepbound for weight loss. Mounjaro nearly doubled sales in 2025 to $22.97 billion, while Zepbound surged 175% year-on-year to make $13.54 billion. Despite being a late entrant to the GLP-1 game—tirzepatide was first approved as Mounjaro in May 2022, while Novo Nordisk’s Ozempic was cleared in January 2020 —Lilly has cleanly overtaken its competitor with a rapid ramp-up in sales that outpaced even Merck’s long-time cancer blockbuster Keytruda. Also helping boost tirzepatide’s case are studies that show the drug to have better weight-loss and glucose control profiles than Novo’s semaglutide. The future continues to look bright for Lilly’s business, as the lead over Novo extends in the obesity space. While the Danish competitor brought a weight-loss pill to the market first—the FDA signed off on an oral formulation of Wegovy late last year —Lilly’s own tablet, a GLP-1 analog called orforglipron, is close behind, with an FDA target action date of April 10 . Orforglipron also appears to have an efficacy edge over oral semaglutide, with the Phase 3 ACHIEVE-3 study demonstrating that Lilly’s pill elicited better sugar control and greater weight reduction . Obesity Lilly’s Weight Loss Trio Could Top $100B in Revenue Thanks to Oral Option If Eli Lilly’s obesity pill orforglipron is approved and priced around $200 per month, analysts at Truist predict patients will flock to it. November 19, 2025 · 1 min read · Annalee Armstrong Read more Merck Slows Down, Focuses on Pipeline as Keytruda’s Cliff Approaches 2025 Revenue: $65.01 billion YoY Growth: 1% During Merck’s full-year 2025 earnings call, an analyst at TD Cowen pressed the pharma on its relatively slow growth last year: “Is this what we should expect from Merck going forward, a company that grows modestly in good times and is significantly pressured in less good times?” Merck in 2025 was bogged down substantially by a slowdown in vaccine sales. Its HPV vaccine Gardasil made $5.23 billion globally last year—a 39% decrease from 2024. Pneumovax 23, the pneumococcal vaccine, cratered 37% year-on-year and brought in just $166 million in 2025. Thankfully for Merck, the blockbuster PD-1 inhibitor Keytruda, which by now has become a cornerstone cancer therapy, continued its strong market performance, growing 7% to bring in $31.64 billion. Keytruda remains the industry’s top-selling drug , but it’s on a timer. Key protections for Keytruda are set to expire in 2028 , after whichsales are expected to erode as biosimilars enter the market. Merck has been preparing for this, however, and last year secured an FDA approval for Keytruda Qlex, a subcutaneous formulation of the cancer therapy, which the pharma—and analysts—say will help cushion Keytruda’s fall off the patent cliff. The under-the-skin injection made $40 million worldwide last year in its initial months. The approval of Keytruda Qlex is part of why CEO Robert Davis pushed back against the TD Cowen comment during the pharma’s investor call. “I’m not sure I agree with your characterization,” Davis told the analyst, insisting that 2025’s modest growth was being taken “out of context.” In particular, Davis pointed to the pharma’s strong push to expand its pipeline—an effort that may not immediately reflect on the topline, but will nevertheless help keep earnings high past Keytruda’s lifespan. In July 2025, the company scooped up Verona Pharma for $10 billion , gaining the commercial drug Ohtuvayre for chronic obstructive pulmonary disease. Then, in November, Merck paid $9.2 billion to acquire Cidara Therapeutics for a late-stage antiviral drug. These deals have helped Merck build what Davis said is “probably the broadest and widest pipeline we’ve had in years.” Earnings Keytruda Hangs On to Best Seller Crown as GLP-1s Gain Ground Merck’s Keytruda will soon lose exclusivity, just as weight-loss giants Eli Lilly and Novo Nordisk press in with their blockbuster GLP-1s. March 4, 2026 · 9 min read · Tristan Manalac Read more Pfizer Pivots Focus to Obesity as Sales Continue Slide 2025 Revenue: $62.579 billion YoY Growth: -2% Rounding out this list is Pfizer, which continues to struggle to regain its footing in a post-pandemic market. The pharma reported an overall 2% year-on-year sales slip to $62.6 billion, but taking its COVID-19 products—the antiviral Paxlovid and the vaccine Comirnaty—out of the equation reveals 6% operational growth. Comirnaty nevertheless remains Pfizer’s best-selling product, making $2.27 billion worldwide. Close behind are the blood thinner Eliquis, which grew 8% year-on-year to bring in $2.02 billion, and the Prevnar family of conjugate vaccines, which racked up $1.71 billion in sales. Notably, with vaccines accounting for much of earnings, Pfizer has been particularly exposed to policy headwinds in the U.S., driven by continued critical rhetoric and controversial vaccine policies from Health Secretary Robert F. Kennedy, Jr. So much so, in fact, that Pfizer CEO Albert Bourla felt the need to speak up about it at the World Economic Forum in January. To return to growth, Pfizer is leaning heavily into the already-lucrative but increasingly competitive obesity market. The pharma previously tried to advance its own GLP-1 drug danuglipron, but was forced to pull the plug amid safety issues. Late last year, Pfizer won over Novo in a public bidding war for Metsera, ultimately paying $9.8 billion to acquire the biotech. The pharma has since put more money into its weight-loss pipeline, including a potential $1.9 billion deal with China’s YaoPharma in December 2025 for an investigational GLP-1 drug, as well as a $495 million partnership with Sciwind Biosciences in February to license a GLP-1 injection called ecnoglutide, which is approved in China for diabetes. .responsive-container { display: flex; flex-wrap: wrap; border: 1px solid #ededed; font-family: Helvetica, Arial, Sans-Serif; padding: 20px 20px 10px 20px; } .column-left { flex: 1; max-width: 45%; padding: 20px 20px 10px 20px; } .column-right { flex: 2; padding: 20px 20px 10px 20px; } @media (max-width: 768px) { .column-left, .column-right { max-width: 100%; flex: 100%; padding: 10px 0; } } Subscribe to BioPharm Executive! 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