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Lilly’s Phase 2 data strengthens hopes for a new revenue stream

New-generation obesity drugs centered on amylin are emerging as a growth area that is likely to complement, rather than replace, GLP-1 therapies. In a Phase 2 study released this week, Lilly reported that its experimental amylin drug eloralintide significantly increased weight loss in patients with obesity and type 2 diabetes when used together with tirzepatide.

In the 48-week study, patients on the highest-dose combination lost an average of 23.3% of their body weight, compared with 14.8% in the group that used only high-dose tirzepatide. Lilly said those figures were calculated from an efficacy analysis that assumed patients stayed on treatment throughout the trial. The company is developing eloralintide both as a standalone therapy and as part of a combination regimen.

What stands out most for the market is the revenue potential of the program. David Risinger, an analyst at Leerink Partners, estimates that Lilly’s eloralintide products could generate annual sales of $23.2 billion by the end of 2035. Under that forecast, the standalone drug is expected to reach the market in 2029, while the combination is projected to launch in 2030.

Side effects and Phase 3 trials will shape the investment case

Even so, Lilly still faces an important test. Because the data come from a relatively small Phase 2 trial, the company will need to confirm the results in Phase 3 studies due to start this year.

Dropout rates linked to side effects are also being closely watched. In the combination arm, they ranged from 10.8% to 27%, depending on dose, while the rate remained at 2.9% in the group receiving tirzepatide alone. Experts note that weight loss is often more limited in patients with type 2 diabetes, making additional efficacy commercially important, but long-term tolerability will be at least as critical as efficacy.

Analysts say there could be a potential patient pool of more than 10 million people who do not get enough benefit from GLP-1 therapies alone, experience side effects, or do not respond adequately for biological reasons. That could create an independent market for amylin-based drugs.

Novo and other drugmakers are also betting on the same target

Novo Nordisk has long been pursuing a similar strategy. The company’s amylin-based candidate cagrilintide produced meaningful weight loss on its own in a late-stage study, while CagriSema, which combines it with semaglutide, delivered stronger results in clinical trials. CagriSema is expected to launch early next year, while standalone cagrilintide and the higher-dose version of CagriSema are expected in 2028.

Novo is also working on amycretin and zenagamtide, which combine GLP-1 and amylin activity in a single molecule. The candidate, being tested as a weekly injection and an oral daily tablet, delivered promising Phase 2 results earlier this year. The fact that companies such as Pfizer, AstraZeneca and Viking Therapeutics are also advancing their own amylin programs shows that competition in the obesity drug market is shifting to a new axis.

Amylin increases feelings of fullness and suppresses appetite, but it does so through a different biological pathway than GLP-1. For that reason, the industry believes that combinations targeting multiple hormone pathways could expand both clinical outcomes and long-term revenue potential, rather than relying on dose increases alone. Still, more clinical data and regulatory approvals are needed before these drugs can be said to outperform tirzepatide or other next-generation therapies.

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