AstraZeneca has unveiled data from two Phase IIb trials of its in-licensed oral glucagon-like peptide-1 receptor agonist (GLP-1RA), touting a 10.5% weight loss in patients.
Data from the VISTA and SOLSTICE trials of elecoglipron, which was licensed from Eccogene in 2023, were unveiled at the American Diabetes Association (ADA) meeting 2026, which was held in New Orleans from 5-8 June, and simultaneously published in The Lancet. AstraZeneca previously announced that the trials met their endpoints, but did not unveil any data.
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VISTA, which enrolled adults with obesity or overweight and at least one comorbidity receiving elecoglipron (75mg), achieved one of its dual primary endpoints of clinically meaningful and statistically significant average reduction in body weight – a value of10.5% at 26 weeks compared to 0.6% with placebo.
Weight loss in patients receiving elecoglipron did not plateau, reaching 11.8% at 36 weeks versus 0.3% with placebo.
The trial also met the dual primary endpoint of proportion of patients achieving at least 5% weight loss at 26 weeks, with up to 88.8% of participants receiving elecoglipron achieving this threshold.
Finally, patients treated with elecoglipron saw clinically meaningful improvements in several exploratory analyses of cardiometabolic risk factors, including lower blood pressure and C-reactive protein levels, a marker of systemic inflammation.
Meanwhile, SOLSTICE enrolled adults with type 2 diabetes. Those who received elecoglipron (75mg) achieved a clinically meaningful and statistically significant average reduction in HbA1c of 1.9% from baseline at 26 weeks compared to 0.2% with placebo, meeting the trial’s primary endpoint.
The majority of participants receiving elecoglipron achieved guideline-recommended glycaemic targets by 26 weeks, with 90% reaching an HbA1c of less than 7% and 85% reaching an HbA1c of 6.5% or lower.
Patients also achieved a clinically meaningful average reduction in body weight of 7.7% at 26 weeks compared to 1.7% with placebo.
The safety profile of elecoglipron was consistent with the GLP-1 RA class, with adverse events (AEs) being predominantly gastrointestinal and of mild to moderate severity.
AstraZeneca will use the Phase II data to inform its design of the dose escalation schedule in a Phase III programme.
Honorary consultant diabetologist at University Hospitals of Leicester NHS Trust and principal investigator for VISTA, Professor Melanie Davies, said: “Despite huge progress in the field of obesity management, significant opportunity remains to deliver broader, sustainable and more meaningful health benefits for the billions of people living with obesity or weight-related complications. The VISTA results show that people receiving once-daily oral elecoglipron achieved significant weight loss as well as lower blood pressure and systemic inflammation, demonstrating its potential to treat both obesity and its related complications.”
While Vanita Aroda, director of diabetes clinical research at Brigham and Women’s Hospital, Associate Professor at Harvard Medical School and principal investigator for SOLSTICE, said: “In the SOLSTICE trial, the significant HbA1c and weight loss results achieved with elecoglipron show its potential to become an important treatment option for people with type 2 diabetes. As many as eight of every 10 patients who received elecoglipron reached their guideline-recommended glycaemic targets, which we know are linked with better outcomes and long-term health.”
AstraZeneca already confirmed the data would allow elecoglipron to advance to Phase III trials. This programme includes the EMBOLD Phase III trials, which will evaluate elecoglipron as treatment for people with obesity or overweight, with and without type 2 diabetes. The ELUMINATE Phase III trials will evaluate elecoglipron as monotherapy and in combination with Forxiga (dapagliflozin), as treatment for people with type 2 diabetes. Additional outcome trials will focus on long-term cardiovascular and kidney outcomes.
Oral obesity market filling up
If elecoglipron is successful in Phase III and makes it to market, it is set to face competition from GLP-1RA leaders Novo Nordisk and Eli Lilly. Both leaders in the space have already gained approval of their oral GLP-1RAs for weight loss, with Novo Nordisk holding the first-to-market advantage following its December 2025 approval for oral Wegovy (semaglutide). Eli Lilly’s Foundayo (orforglipron) was given approval from the US Food and Drug Administration (FDA) on 1 April 2026.
Following these approvals, the market is set to grow heavily in the coming years. Other companies, including Structure Therapeutics and Vincentage Pharma, are also investigating late-stage oral GLP-1RAs.
According to GlobalData’s Pharmaceutical Intelligence Center, the total GLP-1RA pill market is forecast to increase from $3.2bn in 2025 to $34.3bn in 2031, representing a compound annual growth rate (CAGR) of 48.4% over the period. Total pill revenues are estimated to represent a fifth of total GLP-1RA drug sales (pill + injectables) by 2031.
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