Semaglutide (Novo Nordisk)

AstraZeneca and insitro will work in tandem to discover and develop drugs for cardiometabolic diseases, namely MASH and cardiomyopathies. Credit: Tada Images / Shutterstock.com. AstraZeneca has inked a billion-dollar artificial intelligence (AI)-powered drug discovery partnership and licensing deal with insitro, to identify novel targets and therapies for a range of cardiometabolic diseases. Through this partnership, the pair will focus on creating drugs to fulfil unmet needs and address the underlying drivers of disease in both metabolic dysfunction-associated steatohepatitis (MASH) and heart muscle-impacting cardiomyopathies. In exchange for an upfront payment of $40m and around $1.46bn in potential development and commercial milestones, AstraZeneca will secure the exclusive global rights to develop selected programmes developed through this partnership. The UK-Swedish pharma giant will also award insitro single-digit royalties on global sales of the fruits of this collaboration, provided they make it to market. At the heart of this partnership is insitro’s Virtual Human AI platform trained on large-scale human and cellular data, which the biotech uses to identify causal disease biology. According to insitro’s founder and CEO, Daphne Koller, applying AI to complex datasets around MASH and cardiomyopathies can allow the pair to “unlock greater discovery power” and reveal new insights into the genetics behind such diseases. “Our platform simultaneously deconvolutes disease biology and identifies causal drivers of disease pathologies,” Koller commented, adding that pairing expertise with AstraZeneca will allow the duo to scale with the potential to more rapidly progress novel programmes through the development stages to patients. AstraZeneca targets increasingly lucrative MASH arena AstraZeneca forges its collaboration as the company looks to deepen its legacy in the cardiovascular, renal and metabolic (CVRM) segment. Currently, the pharma giant has a plethora of marketed medicines in this disease area – including blockbuster SGLT2 inhibitor, Farxiga (dapagliflozin), which is now subject to generic erosion due to its US loss of market exclusivity earlier this year. It also marks a doubling down on AstraZeneca’s intent to enter the MASH market, as it is currently exploring the potential of a small molecule FAP inhibitor, AZD2389, in Phase II trials. The company hopes it will demonstrate better efficacy than its former antisense oligonucleotide MASH candidate, AZD2693, which it scrapped after it produced lacklustre results in a Phase II study. AstraZeneca makes moves toward the MASH market as it becomes increasingly lucrative, with a recent report from GlobalData, parent company of Pharmaceutical Technology, forecasting that the segment will balloon from a value of $802.3m in 2022 at a compound annual growth rate (CAGR) of 38.2% to a value of $20.3bn by 2032. This growth, analysts say, will primarily be fuelled by the anticipated launch of several pipeline candidates and uptake of established drugs such as Madrigal Pharmaceutical’s first-to-market Rezdiffra (resmetirom) and Novo’s blockbuster glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy, Wegovy (semaglutide) , as well as an anticipated uptick in the use of non-invasive tests for diagnosing and managing the disease. With this shifting MASH landscape, GlobalData analysts also point to burgeoning competition in this space, the flames of which are stoked by the potential emergence of further incretin therapies and alternative investigational antifibrotics on the market.

The opinion will now be sent to the European Commission (EC) for a final decision on marketing authorisation. Credit: Below the Sky/Shutterstock.com. A European Medicines Agency (EMA) panel has backed Eli Lilly’s Foundayo (orforglipron) for approval, helping the drugmaker close the gap on Novo Nordisk in the obesity pill arena. The agency’s human medicines committee (CHMP) endorsed Foundayo for both weight loss and type 2 diabetes. As with other glucagon-like peptide-1 receptor agonists (GLP-1RAS), the therapy is intended for use alongside a healthy diet and physical activity. The backing means Foundayo is likely to become the second oral GLP-1RA approved in the EU after Novo Nordisk’s oral Wegovy (semaglutide). The Danish drugmaker has raced ahead in the oral GLP-1RA space, with Lilly second to market in the US , UK, and Europe. However, Novo’s pill is approved in these territories for weight management only. Alongside facing off against oral Wegovy in obesity, Foundayo will now directly compete with Novo’s Rybelsus brand of oral semaglutide in type 2 diabetes. The pill remained a blockbuster drug in 2025 despite increased competition. Rybelsus comes in lower doses tailored for blood sugar control. Lilly’s ATTAIN-1 (NCT05869903) and ATTAIN-2 (NCT05872620) studies, both Phase III trials, demonstrated that adults with obesity on the highest dose of the pill lost up to 11.2% of their body weight, compared to a ceiling of 2.5% in the placebo group. The ACHIEVE programme, which evaluated Foundayo in type 2 diabetes patients, reported significant improvements in blood sugar control and body weight. Novo’s pivotal OASIS programme (NCT05035095, NCT05564117) revealed that the highest dose of its tablet led to weight loss of around 13.6%. Given its first-mover advantage, oral Wegovy is currently leading GLP-1RA pill revenue. It generated around $850m in sales worldwide in the first half of this year, while Foundayo generated just shy of $100m, solely in Q2 following its later launches. Foundayo’s advantage over oral semaglutide is that it does not have meal restrictions with administration. Novo’s compound, on the other hand, must be taken on an empty stomach each morning. Analysts remain unsure whether this convenience will translate to stronger adoption than oral Wegovy. While the approval of oral GLP-1RAs are transforming the cardiometabolic arena, injectables still retain a dominant position. In Q2, Lilly’s performance was fuelled by tirzepatide brands Mounjaro and Zepbound, with the type 2 diabetes and obesity drugs accounting for around 64% of revenue. Mounjaro sales spiked 91% to hit $9.9bn, while Zepbound grew 44% to $4.9bn. This far out-performed Novo’s injectable semaglutide franchise, which brought in $7.8bn globally. Indeed, analysis by GlobalData says that tirzepatide holds the potential to outperform oral and injectable semaglutide in type 2 diabetes patients. Real-world data presented at the European Association for the Study of Diabetes (EASD) Annual Meeting 2026 showcased the drug’s higher effectiveness in helping patients achieve glycaemic and weight-loss targets. GlobalData pharma analyst Maria Alexandrovich said: “In an increasingly competitive incretin market, these data could help differentiate tirzepatide from semaglutide. Its benefits across both glycaemic control and weight loss may increase its relevance as treatment decisions increasingly consider outcomes beyond HbA1c alone.”