India Pharma Outlook Team | Saturday, 28 February 2026
Eli Lilly and Company reported that its investigational oral GLP-1 receptor agonist, orforglipron, achieved superior oral GLP-1 receptor agonist performance in type 2 diabetes management compared with oral semaglutide in a head-to-head phase 3 trial.
Results from the 52-week ACHIEVE-3 study, published in The Lancet, showed that orforglipron 12 mg and 36 mg doses delivered greater A1C reduction and weight loss than semaglutide 7 mg and 14 mg, meeting the primary endpoint and all key secondary endpoints.
The randomized, open-label trial enrolled 1,698 participants with inadequately controlled diabetes on metformin across multiple countries. The study met its objective of demonstrating non-inferiority and statistical superiority in blood sugar control, with improvements observed by week four and sustained through week 52.
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In addition to glycaemic outcomes, orforglipron improved cardiovascular risk factors, including reductions in non-HDL cholesterol, total cholesterol, triglycerides and systolic blood pressure, along with increased HDL cholesterol.
Safety findings were consistent with the GLP-1 class. Common adverse events included nausea, diarrhoea, vomiting, dyspepsia and decreased appetite. Discontinuation rates due to adverse events were higher with orforglipron compared with semaglutide.
Orforglipron is a once-daily, non-peptide oral therapy that can be taken without food or water restrictions, positioning it as a potential alternative in the expanding GLP-1 market. The company has filed the drug for regulatory approval in more than 40 countries, with potential US action for obesity expected in the second quarter of 2026.
The broader ACHIEVE program has enrolled over 6,000 participants globally, with additional data expected later this year, strengthening its profile in diabetes treatment and obesity management.
