What happened this week in GLP‑1 medications?
Every significant GLP-1 development since 2017, dated and sourced: 2,001 events across approvals, trials, prices, lawsuits, compounding and culture.
Latest
- Business
Eli Lilly raises 2026 outlook after Q3 revenue rises 39% to $24.4 billion
Eli Lilly reported third-quarter 2026 revenue of $24.40 billion on October 29, up 39% from a year earlier and above the $22.61 billion analysts expected, with adjusted earnings per share of $7.48 versus $6.26 expected. The company raised full-year revenue guidance to $91 billion–$92 billion from $85 billion–$87 billion. Mounjaro revenue rose 65% to $10.72 billion and Zepbound rose 49% to $5.35 billion, while the newly launched Foundayo brought in $184 million, below the $229 million estimate.
- Research and trials
Lilly's retatrutide tops Ozempic 2 mg on A1C and weight loss in Phase 3 trial
In a Phase 3 head-to-head trial reported on October 28, 2026, the highest dose of Eli Lilly's retatrutide lowered A1C by 2.2 percentage points after 80 weeks, compared with 1.8 points for Ozempic 2 mg. Patients on retatrutide lost 20.9% of body weight versus 9.4% on Ozempic, based on on-treatment analyses.
- Research and trials
Ascletis oral GLP-1 ASC30 cuts HbA1c 1.7% in Phase 2 diabetes trial
Ascletis said on October 28, 2026, that its oral small molecule GLP-1 receptor agonist ASC30 met the primary endpoint in a 13-week U.S. Phase 2 trial of 100 people with type 2 diabetes. Placebo-adjusted HbA1c reductions at 12 weeks were 1.7%, 1.6% and 1.7% at 40 mg, 60 mg and 80 mg, and placebo-adjusted weight loss at 13 weeks was 4.4%, 3.8% and 4.0%. The company reported no study discontinuations due to gastrointestinal adverse events and no hepatic safety signal.
- Research and trials
Vanda's tradipitant cut Wegovy-induced vomiting by 27% in Phase 3 trial
In Phase 3 Study 3601, announced October 27, 2026, tradipitant reduced the incidence of vomiting to 43% compared with 58.5% for placebo in patients given a single 1 mg dose of Wegovy. Severe nausea and vomiting occurred in 33.1% of tradipitant patients versus 50.6% on placebo. Vanda Pharmaceuticals said it plans a supplemental new drug application to expand the label.
- Prices
Employer coverage of Wegovy and Zepbound for weight loss falls to 53%, survey finds
A WTW survey dated October 27, 2026 found 53% of employers with more than 100 employees cover GLP-1 drugs for weight loss, down from 57% in 2025, and 16% are weighing dropping the benefit, up from 9%. A separate projection put employer health insurance costs at 8.2% higher per employee in 2027, with GLP-1 use accounting for a full percentage point of that increase.
- Competition
Judge denies Novo Nordisk request to block Lilly's Zepbound and Mounjaro ads
A U.S. federal judge on October 26, 2026 refused to grant Novo Nordisk a preliminary injunction against Eli Lilly's comparative advertising for Zepbound and Mounjaro, ruling that Novo had not shown irreparable harm. One Lilly commercial cited in the case said Zepbound users lost an average of 50 pounds compared with 33 pounds for Wegovy. Novo Nordisk said the ruling does not decide whether Lilly's advertising is false or misleading and that the litigation continues.
- Business
Oral GLP-1 developer Corxel to go public via SPAC merger
Corxel Pharmaceuticals plans to list on Nasdaq by merging with Amanat Acquisition Corp, a deal paired with a $300 million PIPE that is expected to raise about $377 million in total. The company's lead candidate, CX11, is an oral GLP-1 in late-stage development; Phase 2 data showed up to 11.5% body weight loss at 36 weeks. The transaction is expected to close in the first half of 2027.
- Safety
Case report ties tirzepatide to lithium toxicity in a bipolar patient
A case report dated October 26, 2026, describes a 50-year-old woman with bipolar disorder who developed tremor, slurred speech, and blurred vision three weeks after starting tirzepatide. Her serum lithium level rose from 0.7 to 1.2 mmol/L, and reducing her lithium dose resolved the symptoms. The report says this is the fourth reported case of tirzepatide-associated lithium toxicity.
- Research and trials
ACOG releases first GLP-1 pregnancy guidance, advises against use while pregnant
On October 23, 2026, the American College of Obstetricians and Gynecologists issued its first guidance on GLP-1 receptor agonists during pregnancy and breastfeeding. The guidance recommends stopping a GLP-1 weight-loss drug one to two months before trying to conceive and avoiding the drugs during pregnancy. It says the medications may be considered while breastfeeding after a baby's first month.
- Research and trials
Menopause hormone therapy linked to more weight loss on semaglutide and tirzepatide
A study of about 3,900 women, dated October 21, 2026, found that menopause hormone therapy was associated with greater weight loss from GLP-1 drugs. At one year, women taking hormone therapy plus semaglutide lost an average of 11% of body weight versus 9.5% on semaglutide alone, and 22% of combination users lost at least 20% versus 18% on semaglutide only. Tirzepatide plus hormone therapy showed smaller improvements, including 6.6% versus 5.9% weight loss at three months.
- Research and trials
Retatrutide cut sleep apnea severity by up to 24 AHI events per hour in Phase 3 trials
In two Phase 3 TRIUMPH trials reported October 20, 2026, retatrutide 9 mg and 12 mg lowered the apnea-hypopnea index by 24.4 and 21.9 events per hour more than placebo in adults with obstructive sleep apnea and obesity who did not have diabetes. Among participants with type 2 diabetes, the reductions versus placebo were 14.4 and 15.1 events per hour. Body weight fell 12.5% to 22.2% with retatrutide compared with 4.8% to 5.6% with placebo, and the most common adverse events were gastrointestinal.
- Research and trials
CagriSema linked to 25% average weight loss in women in REDEFINE 1 analysis
In post hoc analyses of the Phase 3 REDEFINE 1 trial presented October 20, 2026 at The Menopause Society, CagriSema 2.4 mg/2.4 mg produced an average 25.0% weight loss at 68 weeks in 2,309 women with obesity or overweight, versus 3.0% with placebo. Weight loss was 26.7% in premenopausal, 24.8% in perimenopausal and 23.1% in postmenopausal women. Novo Nordisk said the analyses are hypothesis-generating and require further study.
- Regulation
Apothecary Pharma recalls 22 lots of compounded tirzepatide over sterility concerns
Apothecary Pharma is voluntarily recalling 22 lots of 18 mg/mL, 4 mL sterile multi-dose vials of compounded tirzepatide, according to a notice dated October 20, 2026. The recall follows an FDA warning letter that found serious sterility deficiencies. The FDA classified the action as Class II, indicating a moderate risk of temporary or medically reversible adverse health consequences.
- Regulation
EMA panel recommends approval of Lilly's oral GLP-1 Foundayo
The European Medicines Agency's CHMP recommended on October 16, 2026, that Foundayo (orforglipron) be granted marketing authorization for weight management and type 2 diabetes in adults. The weight-management recommendation is based on two studies of more than 4,740 adults with obesity or overweight, in which participants lost about 5% to 11% of their body weight after 72 weeks, depending on dose. The once-daily tablet can be taken at any time of day, with or without food.
- Research and trials
Fractyl's Revita cuts weight regain after GLP-1 stop in REMAIN-1 trial
Fractyl Health reported six-month results from the REMAIN-1 pivotal cohort showing Revita-treated participants kept about 80% of their GLP-1-induced weight loss versus 67% with sham, a difference with p=0.0023. In a post hoc analysis, patients with a completed duodenal ablation of at least 20 cm regained 3.8% of total body weight compared with 8.2% for sham. Fractyl plans a De Novo marketing application to the FDA in late Q4 2026 and expects one-year data in Q1 2027.
- Compounding
FDA finds black mold and filth at two Chinese plants making compounded GLP-1 ingredients
FDA inspectors documented black mold on equipment, gross contamination on floors, and employees hiding paperwork or pouring out product samples at one Chinese plant that makes components for compounded semaglutide and tirzepatide. At a second plant, inspectors found evidence of bogus documentation, according to reports released under a Freedom of Information Act request and dated October 15, 2026.
- Compounding
Eli Lilly sues four compounding pharmacies over copycat weight-loss drugs
Eli Lilly filed four lawsuits on October 14, 2026, alleging that compounding pharmacies sold unauthorized copies of its GLP-1 weight-loss drugs. The suits name compounded versions of tirzepatide, the active ingredient in Mounjaro and Zepbound, and compounded semaglutide, the active ingredient in Ozempic and Wegovy.
- Research and trials
Orforglipron matches insulin glargine on cardiovascular safety in ACHIEVE-4
Daily orforglipron was noninferior to insulin glargine for major adverse cardiovascular events in the Phase 3 ACHIEVE-4 trial, results reported on October 14, 2026. In 2,749 adults with type 2 diabetes and obesity or overweight at increased cardiovascular risk, the four-component MACE rate was 4.2% with orforglipron versus 5.0% with insulin glargine over a median two years (hazard ratio 0.84; 95% CI 0.59–1.20; p<0.0001 for noninferiority). Gastrointestinal adverse events were more common with orforglipron (62.1% vs 14.2%), while clinically significant or severe hypoglycemia (6.8% vs 19.2%) and death (1.4% vs 3.2%) were less common.
- Research and trials
GLP-1 drugs linked to 24% fewer schizophrenia hospital visits in study
A study of US health records published in Lancet Psychiatry on October 14, 2026 found that patients with schizophrenia who took GLP-1 drugs for diabetes had 24% fewer psychiatric hospital admissions. The same analysis reported 29% fewer emergency room visits for mental health crises among those patients. The researchers did not establish that the drugs caused the reduction.
- Research and trials
Viking Therapeutics starts Phase 3 trials of oral VK2735 for obesity
Viking Therapeutics announced on October 14, 2026 that it began the SUNRISE Phase 3 program for oral VK2735, its dual GLP-1/GIP receptor agonist. The program has two randomized, double-blind, placebo-controlled trials: SUNRISE-1 in adults with obesity or overweight without type 2 diabetes, and SUNRISE-2 in adults with type 2 diabetes. Each trial targets 560 participants taking once-daily doses of 27.5 mg, 35 mg, 55 mg, or placebo for 68 weeks, with percent change in body weight from baseline versus placebo as the primary endpoint.
- Research and trials
Verdiva Bio ends Phase 2 trial of oral GLP-1 VRB-101 for injectable switch patients
Verdiva Bio terminated a Phase 2 study of VRB-101, an experimental once-weekly oral GLP-1, that tested it as a maintenance option for patients who had lost weight on injectable GLP-1 drugs. The company cited market evolution when it announced the decision on October 14, 2026; the trial had enrolled eight participants before it ended. Verdiva said it will continue developing VRB-101 as a monotherapy.
- Safety
FDA received two death reports linked to counterfeit retatrutide
The FDA received reports of two recent deaths tied to counterfeit versions of retatrutide, an investigational weight-loss drug from Eli Lilly that is not approved for sale. The reports were described by CBS News via MedPage Today in a story dated October 13, 2026. Counterfeit products sold as retatrutide have no guaranteed ingredient, dose or sterility.
- Business
Walmart to cover Ozempic and Mounjaro at no cost for employees with Type 2 diabetes
Walmart said it will cover more than 250 prescriptions, including some insulin, inhalers and GLP-1s, at no cost to employees starting in 2027. Under the plan announced Oct. 13, 2026, Ozempic and Mounjaro will be free for employees with Type 2 diabetes after prior authorization. GLP-1s prescribed for weight loss are still not covered.
- Business
Roche licenses Rona's ALK7 RNAi obesity drug in deal worth up to $1.16B
On October 13, 2026, Roche agreed to license Rona Therapeutics' investigational ALK7-targeting RNAi candidate for obesity and metabolic diseases, gaining exclusive rights. Roche will pay up to $100 million upfront and in near-term milestones, plus up to $1.06 billion in longer-term milestones and royalties. The drug has not been approved, and the totals depend on hitting development and sales targets.
- Business
Zealand Pharma and Generate Biomedicines sign obesity drug deal worth up to $1.2 billion
Zealand Pharma and Generate Biomedicines announced on October 13, 2026 that they will partner to develop AI-designed obesity drugs, in a deal worth up to nearly $1.2 billion in milestone payments. Generate Biomedicines will receive $30 million upfront and up to $35 million in early preclinical milestones. Generate will lead research through candidate selection, while Zealand handles clinical development, regulatory submissions and worldwide commercialization of the multispecific protein therapies.
- Research and trials
Lilly says Taltz plus Zepbound shifted more biomarkers than Taltz alone in psoriasis-obesity trial
Exploratory Phase 3b data from the TOGETHER-PsO trial, presented October 9, 2026 at Fall Clinical, showed Taltz (ixekizumab) plus Zepbound (tirzepatide) changed 482 proteins and 467 genes by week 36, compared with 140 proteins and 16 genes for Taltz alone. Lilly reported that broader biomarker responses, including reduced inflammatory immune activity, appeared as early as week 12. The company did not present clinical symptom outcomes for the comparison.
- Research and trials
Petrelintide from Zealand and Roche shows up to 9.2% weight loss in Phase 2 trial
In a 220-patient Phase 2 trial reported October 7, 2026, once-weekly petrelintide produced 7.4% to 9.2% body weight reduction at 28 weeks in people with type 2 diabetes, compared with about 2% for placebo. HbA1c fell by up to 0.65 percentage points. Gastrointestinal side effects led 1.9% of patients on petrelintide to discontinue, versus 1.7% on placebo.
- Safety
GLP-1 users report more nail disorders, including detachment, in EADV study
A multinational cross-sectional study of 575 GLP-1 receptor agonist users and 1,329 controls, presented at EADV 2026 and dated October 7, 2026, found that 66.3% of users reported at least one nail disorder versus 52.8% of controls. Nail detachment, or onycholysis, had an odds ratio of 6.84, and hair loss was also more common in the GLP-1 group. The cross-sectional design cannot establish that the medications caused these conditions.
- Research and trials
Viking starts oral maintenance dosing study of VK2735 after injectable weight loss
Viking Therapeutics said it began Part 2 of a two-part trial testing whether about 195 adults with obesity can hold onto weight lost with weekly injections of VK2735 by switching to daily or weekly oral tablets, monthly or every-other-week injections, or placebo. All participants first receive weekly subcutaneous VK2735 or placebo for 21 weeks, then move to a maintenance regimen through Week 33, with safety, tolerability and pharmacokinetics as the main objectives. Results are expected in 2027.
- Research and trials
CVS Caremark adds Zepbound back to commercial formularies starting October 1
CVS Caremark began covering Zepbound (tirzepatide) again on its commercial template formularies on Oct. 1, 2026, as an additional preferred option alongside Wegovy (semaglutide). The change was announced May 28, 2026, and applies only to plan sponsors that adopt the template; tiers and copays are set by each sponsor and were not specified.
- Prices
Zepbound returns to CVS Caremark commercial formularies on Oct. 1
CVS Caremark added Zepbound (tirzepatide) back to its commercial formularies as an additional preferred weight-management option, effective Oct. 1, 2026, alongside Wegovy. For eligible commercially covered patients, Zepbound and the newly unblocked oral drug Foundayo are available for as little as $25 a month, while eligible Medicare Part D beneficiaries may pay $50 a month through a federal demonstration that runs through Dec. 31, 2027.
- Research and trials
Survodutide hits 13.1% weight loss in phase 3 diabetes trial as Zealand shares fall
Boehringer Ingelheim and Zealand Pharma reported that survodutide produced up to 13.1% average weight loss at 76 weeks in adults with obesity or overweight and type 2 diabetes, versus 3.1% on placebo, in the Phase 3 SYNCHRONIZE-2 trial. Under a second analysis in the New England Journal of Medicine, weight loss on the 6 mg dose was 9.8% versus 3.9% on placebo. Zealand shares fell as much as 13% in Copenhagen, and survodutide is not approved for any use.
- Prices
Rhode Island Medicaid ends weight-loss GLP-1 coverage on October 1
Rhode Island's enacted fiscal 2027 budget restricts Medicaid coverage of GLP-1 weight-management drugs to type 2 diabetes and other federally required indications starting October 1, 2026. Weight-management coverage, including Zepbound, runs through September 30. Rhode Island is one of 11 state Medicaid programs an independent tracker counted as covering GLP-1s for weight loss as of July 10, 2026.
- Research and trials
Lilly projects lower 10-year diabetes and heart risk with Foundayo in new analysis
Eli Lilly reported post hoc analyses of its ATTAIN-1 obesity trial on Oct. 1, 2026, projecting that Foundayo (orforglipron) cut estimated 10-year type 2 diabetes risk versus placebo by 45%, 50% and 57% at the 5.5 mg, 9 mg and 17.2 mg doses. The 17.2 mg dose was also linked to an estimated 18% reduction in predicted 10-year cardiovascular disease risk. The figures come from risk models using trial data, not from observed diabetes or heart disease outcomes.
- Research and trials
Digital-first tirzepatide program linked to 16.1 kg mean weight loss in UK women
An observational study published in Nature Medicine on October 1, 2026, followed 8,127 women in the UK who began GLP-1 therapy through a structured digital program, with 99.8% using tirzepatide. Mean weight loss was 16.1 kg, or 15.5% of baseline weight, and at six months 83.1% had lost at least 10% and 22.4% had lost at least 20%. Retention was 91.4%, glycated hemoglobin fell by 3.3 mmol/mol, and no serious treatment-related adverse events were reported.
- Research and trials
Novo reports liver fat fell sharply in 55-person Wegovy sub-study
Novo Nordisk said Oct. 1, 2026 that among 55 adults with obesity in its STEP UP trial, average liver fat measured by MRI dropped from 8.8% to 3.1% after 72 weeks on injectable Wegovy (semaglutide) at the pooled 7.2 mg and 2.4 mg doses. Of the 26 participants who started above 5% liver fat, 23 — 88.5% — finished below that mark. Novo described the analysis as post hoc and exploratory.
- Research and trials
Ribupatide shows up to 20.2% weight loss in Phase 2 trial of women with PMOS
Kailera Therapeutics and Jiangsu Hengrui Pharmaceuticals reported that their weekly injectable GLP-1/GIP dual agonist ribupatide produced up to 20.2% weight loss at 32 weeks in women with polyendocrine metabolic ovarian syndrome, compared with 2.6% on placebo. All three ribupatide dose groups also had more frequent menstrual cycles, while the placebo group's cycles became less frequent. No serious adverse events or adverse events leading to discontinuation were reported.
- Competition
Lilly's retatrutide hits Phase 3 goals, with FDA filing planned for early 2027
Eli Lilly reported that its investigational drug retatrutide met the main goal of two Phase 3 trials, with average weight loss of up to 55.8 pounds (22.6%) at 80 weeks in adults with severe obesity and cardiovascular disease, and up to 49.6 pounds (20.8%) in adults with type 2 diabetes. Lilly plans to file for U.S. approval in the first quarter of 2027. Amgen, which is developing the competing drug MariTide, has not reported Phase 3 results or a date for them.
- Research and trials
Lilly says eloralintide-tirzepatide combo beat tirzepatide alone in mid-stage trial
Eli Lilly reported that an experimental combination of eloralintide and tirzepatide produced up to 23.3% average weight loss and a 2.9-point average A1C drop over 48 weeks in adults with obesity or overweight and type 2 diabetes, compared with 14.8% weight loss and a 2.4-point A1C drop for tirzepatide 15 mg alone. Side-effect-related discontinuation rates were higher on the combination, ranging from 10.8% to 27.0%. Lilly plans to start Phase 3 trials of a single-injection version by the end of 2026.
- Research and trials
Wegovy pill tied to extra 8.8 pounds lost after switching from GLP-1 shots, Novo data show
Novo Nordisk presented real-world data on Sept. 30, 2026, showing that 194 adults with obesity or overweight who moved from a weekly GLP-1 injection to the Wegovy pill lost about 4% of their body weight, or roughly 8.8 pounds, over three months. The analysis, called OCTANE, had no control group, so it cannot show whether the switch caused the additional weight loss.