A study conducted by the Department of Twin Research and Genetic Epidemiology at King’s College London and the National Institute for Health Research (NIHR) BioResource has uncovered new insights on the genetic mechanisms controlling human metabolism. The study analysed the plasma levels of 722 metabolites from blood samples provided by 8,809 European subjects, making it the largest genome-wide association study of metabolite levels to date. Due to the scale of the analyses, the study identified 74 novel genomic regions, influencing human metabolism, that had not been recognised in any previous literature. The findings, which have been published in the journal Metabolites, could aid in the development of precision medicines for conditions such as obesity.

While precision medicines that are tailored to patients’ genetic profiles have revolutionised the treatment of many cancers, this approach has yet to be applied in clinical practice to conditions like obesity. At present, the dominant therapeutic strategy in obesity pharmacological management involves targeting the glucagon-like peptide 1 receptor (GLP1R), which has the effect of regulating appetite. This mechanism is employed by Novo Nordisk’s Saxenda (liraglutide), which has remained a leading global therapy in obesity since 2014, as well as Saxenda’s successor Wegovy (semaglutide), which was launched in the US in June last year.

Wegovy subsequently received approval in the UK and Canada and has been recommended for marketing authorisation by the European Medicines Agency’s Committee for Medicinal Products for Human Use (CHMP). The drug, which demonstrated unprecedented efficacy results in Phase III trials and boasts a convenient once-weekly dosing regimen, has generated a great deal of interest within the obesity field. Despite some initial manufacturing issues that will lead to a short supply of the drug in the US in the first half of this year, Wegovy is expected to attain blockbuster status in the near future.

Although Novo Nordisk is currently dominating the obesity market, a wide range of other companies are attempting to enter this space. According to GlobalData’s pipeline products database, there are 233 companies active within the research and development (R&D) landscape that are collectively developing 363 investigational candidates. In addition to its substantial size, the obesity pipeline is also diverse, with 150 distinct molecular targets identified.

While the size and diversity of the pipeline are encouraging, new companies entering the R&D landscape may face an intense level of competition. Obesity is a condition associated with significant heterogeneity, however. Investing in therapies capable of demonstrating strong efficacy or reduced side effects in specific patient subsets could set new players apart from the competition, potentially enabling them to monopolise certain subsections of the market.