Domestic and foreign pharmaceutical companies have stepped up to protect muscles. The obesity treatments Wegovy from Danish pharmaceutical company Novo Nordisk and Mounjaro from American pharmaceutical company Eli Lilly have created a global sensation for obesity drugs, but a problem arose where both fat and muscle are lost. When muscle decreases, immunity drops, and complications can arise. The pharmaceutical companies plan to change the market landscape with next-generation obesity drugs that reduce weight but prevent muscle loss.
According to foreign media reports on the 19th (local time), there are currently 12 corporations conducting clinical trials for next-generation obesity drugs that preserve or increase muscle mass. Notable examples include Eli Lilly and Regeneron from the United States, as well as Hanmi Pharmaceutical and D&D Pharmatech from South Korea, which have also entered the competition.
Wegovy and Mounjaro are glucagon-like peptide-1 (GLP-1) obesity drugs. GLP-1 obesity treatments suppress appetite and result in weight loss of 15–20%, but up to 40% of the lost weight can be muscle loss. Additionally, if the administration of the drug stops, side effects such as decreased basal metabolic rate and a yo-yo effect can occur.
When muscle is lost in the human body, immunity drops, increasing the risk of viral infections and falls. The metabolic regulation function of muscles also declines, leading to complications such as diabetes and hyperlipidemia. The risk of death increases, especially among the elderly. Maintaining muscle is necessary to sustain weight loss without rebound.
Eli Lilly acquired Versanis Bio, developers of the sarcopenia drug 'Bimagrumab,' for $1.93 billion (2.8 trillion won) in 2023. The aim is to develop a follow-up obesity drug that preserves muscle mass while facilitating weight loss by co-administering Bimagrumab and tirzepatide (Mounjaro's ingredient). This follow-up drug is currently in phase 2 clinical trials, with results expected to be announced later this year.
Latecomers are also accelerating the development of next-generation obesity drugs. Regeneron is developing a new drug that not only provides weight loss effects but also maintains body fat, waist circumference, body composition, and thigh muscle mass. The ongoing phase 2 clinical trial is set to be completed next year.
Veru, which developed an oral treatment for COVID-19, is also working on the obesity drug Enobobam, which preserves muscle. In a clinical trial conducted last January involving 168 patients, co-administration of Enobobam and semaglutide (Wegovy's ingredient) reduced muscle loss in elderly patients by 71%.
Hanmi Pharmaceutical is developing an obesity drug that is entirely different from those previously mentioned. Rather than reducing muscle loss, it is designed to increase muscle. This triple-action agent activates GLP-1, as well as glucagon-like peptide (GIP) and glucagon (GCG), and is currently undergoing phase 1 trials in the United States targeting patients with severe obesity. Results are set to be announced at the American Diabetes Association (ADA) meeting in June. From phase 2 onward, global clinical trials will be pursued through technology transfer.
If the obesity drug that successfully maintains muscle mass while providing existing weight loss effects succeeds, the market could shift from phase 1 to phase 2 in the competition against Wegovy and Zepbound. Last month, the U.S. Food and Drug Administration (FDA) proposed in a draft guideline that when applying for approval of obesity drugs, the ratio of muscle mass to body fat should be measured at least twice.
Riley McCarthy, senior project manager at New England Consulting Group (NECG), told Reuters, "While demonstrating weight loss was a key point for the approval of Wegovy and Zepbound by the FDA, future treatments will focus on how long weight loss can be maintained," adding, "If muscle mass maintenance can meet this requirement, it will be a strong new drug."
Veru is additionally conducting clinical trials on how well elderly obese patients can maintain the strength to climb stairs while losing weight. David Risinger, a researcher at U.S. pharmaceutical investment firm Relink, remarked, "The FDA is expected to require functional benefits from future obesity drugs," noting that "Veru's clinical trials are significant."