GLP‑1 news from 2020
15 dated, sourced GLP-1 developments from 2020: approvals, trial results, prices, lawsuits, compounding and culture.
- Business
Novo Nordisk closes $1.35 billion Emisphere deal for oral semaglutide technology
Novo Nordisk completed its $1.35 billion purchase of Emisphere Technologies on December 8, 2020. The deal gave the Danish drugmaker ownership of the SNAC absorption-enhancer technology used to make oral semaglutide tablets, including Rybelsus and a Wegovy pill described as coming in 2026.
- Regulation
FDA approves Saxenda, first GLP-1 for weight management in adolescents 12 and older
The FDA approved Saxenda (liraglutide 3.0 mg) on December 4, 2020, for weight management in patients aged 12 and older with obesity, making it the first GLP-1 receptor agonist cleared for pediatric weight management in the United States. The decision was based on the 56-week SCALE TEENS randomized trial, which enrolled 251 adolescents.
- Regulation
Novo Nordisk filed semaglutide 2.4 mg for chronic weight management in December 2020
Novo Nordisk submitted semaglutide 2.4 mg to the FDA for chronic weight management in December 2020. The agency approved the application on June 4, 2021, under the brand name Wegovy, after a 68-week trial in adults with obesity. Semaglutide is also sold under the brand names Ozempic and Rybelsus.
- Business
Imcivree becomes first obesity drug approved for a specific genetic cause
In November 2020 the FDA approved Imcivree (setmelanotide) for chronic weight management in adults and children aged 6 and older with obesity caused by POMC, PCSK1 or LEPR deficiency confirmed by genetic testing, the first approved therapy for those conditions. In two 52-week trials, 80 percent of patients with POMC or PCSK1 deficiency and 45.5 percent of patients with LEPR deficiency lost more than 10 percent of body weight. The label has since been expanded to include Bardet-Biedl syndrome and, as of a March 2026 revision, acquired hypothalamic obesity and children as young as 2.
- Business
Paper describes how orforglipron activates the GLP-1 receptor
In November 2020, a paper in the Proceedings of the National Academy of Sciences described how LY3502970 — now known as orforglipron — activates the human GLP-1 receptor, calling it an orally active nonpeptide agonist of the receptor. In mice carrying the human receptor, oral doses of 0.1 to 10 mg/kg lowered blood glucose to a similar extent as injected exenatide, and nonhuman primates showed insulin-releasing and appetite-suppressing effects.
- Research and trials
Phase 3 setmelanotide results published for two rare genetic forms of obesity
Two small phase 3 trials published Oct. 30, 2020, in The Lancet Diabetes & Endocrinology found that setmelanotide produced at least 10 percent weight loss in 8 of 10 people with POMC deficiency obesity and 5 of 11 with LEPR deficiency obesity after about a year. Mean hunger scores fell 27.1 percent in the POMC trial and 43.7 percent in the LEPR trial. The trials were single-arm and enrolled 21 people total.
- Research and trials
ADA journal publishes practical guidance on switching between GLP-1 drugs
In October 2020, the American Diabetes Association's journal Clinical Diabetes published a review offering practical guidance for clinicians on switching patients between GLP-1 receptor agonists. The review, led by Dr. Jaime P. Almandoz of UT Southwestern Medical Center, cites pharmacy data suggesting up to one-fourth of patients switch from their first GLP-1 to another glucose-lowering medicine after the first year of treatment. The authors note that practical guidance on managing such transitions is scarce.
- Science
Study describes tirzepatide as an imbalanced dual GIP and GLP-1 receptor agonist
A paper in JCI Insight describes tirzepatide, an experimental dual GIP and GLP-1 receptor agonist, as engaging the GIP receptor more than the GLP-1 receptor and favoring cAMP signaling over beta-arrestin at the GLP-1 receptor. The authors set out a method for calculating receptor occupancy at clinically effective doses and note that in a 26-week phase 2b trial, about 30% of patients on the 15 mg dose reached normal blood sugar and 1 in 4 lost at least 15% of body weight.
- Business
Novo Nordisk's 2020 purchase of Corvidia brought ziltivekimab, which later failed a heart trial
Novo Nordisk agreed on June 11, 2020, to buy Corvidia Therapeutics, an AstraZeneca spin-off, for $725 million upfront and up to $2.1 billion with milestone payments. The deal gave Novo ziltivekimab, an anti-interleukin-6 antibody. About six years later, the drug failed its main cardiovascular outcomes trial.
- Science
Tirzepatide's stomach-slowing effect fades with repeat dosing, study finds
A study published June 10, 2020 in Diabetes, Obesity and Metabolism reports that tirzepatide delayed gastric emptying about as much as semaglutide in mice, but the effect was gone after two weeks of treatment. In a phase 1 human study, a single dose of tirzepatide slowed stomach emptying, and the effect shrank after multiple doses in healthy participants, though some delay remained in people with type 2 diabetes who followed a step-up dosing schedule. A long-acting GIP analog given alone had no effect on gastric emptying.
- Research and trials
Liraglutide reduced BMI in adolescents with obesity in 56-week trial
The New England Journal of Medicine published SCALE TEENS, a randomized trial of 251 adolescents aged 12 to under 18 with obesity. Those assigned to liraglutide 3.0 mg daily had a greater drop in BMI standard-deviation score than those on placebo (estimated difference −0.22; 95% CI, −0.37 to −0.08; P=0.002), with an estimated difference in body weight of −4.50 kg. Gastrointestinal side effects were more common on liraglutide, and BMI rose again after the drug was stopped.
- Business
Trial finds weekly semaglutide 1.0 mg reduced A1C and weight more than daily liraglutide
In the SUSTAIN 10 trial, 577 adults with type 2 diabetes taking once-weekly semaglutide 1.0 mg lowered A1C by an average of 1.7 percentage points and body weight by 5.8 kg at 30 weeks, compared with 1.0 point and 1.9 kg for once-daily liraglutide 1.2 mg. Gastrointestinal side effects and treatment discontinuations were more common with semaglutide, with 11.4% versus 6.6% stopping treatment early.
- Competition
FDA asks Eisai to withdraw weight-loss drug Belviq over cancer signal
The FDA asked Eisai on Feb. 13, 2020 to withdraw the weight-loss drugs Belviq and Belviq XR (lorcaserin) after the CAMELLIA-TIMI 61 trial found cancer in 7.7 percent of lorcaserin patients versus 7.1 percent on placebo. Eisai agreed to the voluntary withdrawal but said its interpretation of the data differed from the FDA's. The agency later determined the products were withdrawn from sale for reasons of safety or effectiveness.
- Regulation
FDA clears Ozempic for cardiovascular risk reduction in adults with type 2 diabetes and heart disease
On January 16, 2020, the FDA granted Ozempic (semaglutide) injection a new indication: lowering the risk of major adverse cardiovascular events in adults who have type 2 diabetes and established cardiovascular disease. Novo Nordisk filed the request on March 20, 2019, and the decision rested on the SUSTAIN 6 outcomes trial. The letter does not give the size of the risk reduction seen in that trial.
- Business
Lilly's tirzepatide manufacturing bet, begun in 2020, grows past $50 billion
Eli Lilly started committing money to new factories in 2020 based on research results for tirzepatide, the molecule in Mounjaro and Zepbound, before either drug was approved. The buildout has since grown from an $18 billion figure covering the U.S. and Europe in May 2024 to more than $50 billion in planned U.S. commitments announced in February 2025.