Do Patients Benefit As Domestic and International Weight Loss Drug Companies Battle it Out?(AI Translation)

【周刊提前读】国内外减肥药酣战 患者如何受益？

The article delves into the evolving landscape of obesity treatment in China, emphasizing the shift from conventional approaches to modern pharmacotherapy. A central figure, 32-year-old Jian Cheng, symbolizes the modern patient navigating these new drug therapies, having successfully lost 12% of his body weight using semaglutide and planning a fallback with tirzepatide if weight regain occurs [para. 1][para. 2].

Semaglutide and tirzepatide, both from major pharmaceutical companies Novo Nordisk and Eli Lilly respectively, are the new focal points in weight-loss medication. Semaglutide started as a diabetes medication before gaining approval for weight loss [para. 3][para. 4]. Meanwhile, tirzepatide, a dual-target receptor agonist, gained approval for weight loss in China in July 2023 [para. 5][para. 6].

Historically, the development of obesity drugs has faced significant setbacks, with many initially approved medications being withdrawn due to safety concerns. Before the introduction of semaglutide and tirzepatide, Orlistat was the only weight-loss drug available domestically, despite its gastrointestinal side effects and limited effectiveness [para. 7]. The introduction of GLP-1 class drugs, which mimic bodily mechanisms regulating appetite and metabolism, has revolutionized obesity treatment, according to Ji Linong of Peking University [para. 8][para. 9].

Novo Nordisk and Eli Lilly lead the competitive landscape, with Novo Nordisk’s semaglutide achieving significant sales and discussion in 2023 despite being surpassed in total sales by a new "King of Drugs." The weight loss version of semaglutide alone boasted a 400% annual sales increase [para. 11][para. 12]. With the launch of tirzepatide, Eli Lilly quickly gained ground, signifying a fierce competition in China's populous obesity market [para. 14][para. 15].

For clinical experts, the differentiation in drug competition is becoming essential, with the focus shifting from just weight loss to overall health benefits like metabolic and cardiovascular improvements. This competitive fervor also raises questions about whether the weight loss market will genuinely aid obese populations or merely capitalize on market hype [para. 16][para. 17].

Novo Nordisk’s two GLP-1 receptor agonists, Liraglutide, and Semaglutide, highlight evolving strategies from glycemic control to weight management. Semaglutide's initial FDA approval was for glycemic control in 2017, transitioning to weight loss in 2021 under the brand Wegovy. In China, the weight management approval is expected in 2024 [para. 24][para. 25].

Experts indicate that although both Semaglutide and Tirzepatide effectively reduce weight, their clinical applications and the anticipated head-to-head clinical trial results will provide more definitive comparisons. This trial by Eli Lilly, comparing tirzepatide with semaglutide, aims to complete by December 2024 [para. 29][para. 30].

The article also reveals ongoing development in obesity drugs with companies like Pfizer, Boehringer Ingelheim, and Amgen competing by conducting their "head-to-head" trials against semaglutide [para. 47][para. 48]. Multi-target approaches, combining various action mechanisms, are also being explored to enhance efficacy and reduce side effects [para. 44][para. 45].

Domestically, numerous Chinese companies are pushing their GLP-1 drugs through various clinical trials, reflecting significant research and development momentum. The competitive environment includes a mix of innovative approaches and traditional generic drug development as patents for established drugs like semaglutide expire in 2026 [para. 60][para. 61].

Overall, the article emphasizes that while weight loss metrics remain crucial, the broader health benefits, side effect management, and patient convenience are transforming how obesity treatments are developed and perceived [para. 86][para. 87].